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Abstract：
OBJECTIVE: To study the clinical, radiological, and functional outcomes after of radioscapholunate (RSL) fusion for intra-articular malunion of the distal radius.
METHODS: This retrospective study included 26 patients (17 males and 9 females) with intra-articular malunion of distal radius fractures who underwent RSL arthrodesis using locked miniplates (without distal scaphoid excision) between 2012 and 2020. Their mean age was 43 years (range, 32-56). Patients were assessed radiographically for union and clinically for range of motion, grip strength, and pain (assessed by Visual Analogue Scale (VAS) for pain). Functional evaluation was performed by using the Mayo modified wrist score (MMWS) and the Disabilities for the Arm, Shoulder, and Hand (DASH) questionnaire.
RESULTS: All patients showed complete healing at the fusion site after a mean of 8.7 weeks (range, 8-12). The mean follow-up period was 72 months (range, 60-84). The pinch strength improved from a mean of 6.2 kg (range, 3-12) to a mean of 9.8 kg (range, 5-18) which represents 80% of the contralateral side. The mean pinch strength was 7 kg (range, 5-18) which presents 80% of the other side. VAS for pain showed a mean improvement of 72.6%. The DASH score improved to a mean of 19.2 (range, 14-24). The MMWS improved to a mean of 68 (range, 45-86). At the final follow-up period, no degenerative changes were detected in the midcarpal joint.
CONCLUSIONS: RSL arthrodesis (using locked miniplates without distal scaphoid excision) is a reliable surgical procedure to manage cases of radiocarpal OA after intra-articular malunion of distal radius fractures with good clinical and radiological outcomes.
METHODS: Level IV- therapeutic.
METHODS: This retrospective study included 26 patients (17 males and 9 females) with intra-articular malunion of distal radius fractures who underwent RSL arthrodesis using locked miniplates (without distal scaphoid excision) between 2012 and 2020. Their mean age was 43 years (range, 32-56). Patients were assessed radiographically for union and clinically for range of motion, grip strength, and pain (assessed by Visual Analogue Scale (VAS) for pain). Functional evaluation was performed by using the Mayo modified wrist score (MMWS) and the Disabilities for the Arm, Shoulder, and Hand (DASH) questionnaire.
RESULTS: All patients showed complete healing at the fusion site after a mean of 8.7 weeks (range, 8-12). The mean follow-up period was 72 months (range, 60-84). The pinch strength improved from a mean of 6.2 kg (range, 3-12) to a mean of 9.8 kg (range, 5-18) which represents 80% of the contralateral side. The mean pinch strength was 7 kg (range, 5-18) which presents 80% of the other side. VAS for pain showed a mean improvement of 72.6%. The DASH score improved to a mean of 19.2 (range, 14-24). The MMWS improved to a mean of 68 (range, 45-86). At the final follow-up period, no degenerative changes were detected in the midcarpal joint.
CONCLUSIONS: RSL arthrodesis (using locked miniplates without distal scaphoid excision) is a reliable surgical procedure to manage cases of radiocarpal OA after intra-articular malunion of distal radius fractures with good clinical and radiological outcomes.
METHODS: Level IV- therapeutic.
摘要：
目的：为了研究临床，放射学,以及桡骨远端关节内畸形（RSL）融合后的功能结果。
方法：这项回顾性研究纳入了26例（男17例，女9例）桡骨远端骨折关节内畸形愈合患者，这些患者在2012年至2020年期间使用锁定微型钢板进行RSL关节固定术（不使用舟骨远端切除术）。他们的平均年龄是43岁(范围，32-56).对患者进行影像学检查以评估其愈合情况，并在临床上评估其活动范围，握力,和疼痛（通过视觉模拟评分（VAS）评估疼痛）。通过使用Mayo改良腕部评分（MMWS）和手臂残疾进行功能评估，肩膀,手（DASH）问卷。
结果：所有患者在平均8.7周后在融合部位显示完全愈合（范围，8-12).平均随访时间为72个月(范围，60-84).捏合强度从6.2kg的平均值提高(范围，3-12)平均9.8公斤(范围，5-18），代表对侧的80％。平均捏合强度为7kg(范围，5-18），代表了另一面的80%。疼痛的VAS显示平均改善72.6%。DASH得分提高到平均19.2(范围，14-24).MMWS提高到平均值68(范围，45-86).在最后的随访期,腕关节中未见退行性改变。
结论：RSL关节固定术（使用锁定微型钢板，不使用舟骨远端切除术）是治疗桡骨远端骨折关节内不愈合后桡骨OA病例的可靠手术方法，具有良好的临床和放射学结果。
方法：IV级-治疗性。
方法：这项回顾性研究纳入了26例（男17例，女9例）桡骨远端骨折关节内畸形愈合患者，这些患者在2012年至2020年期间使用锁定微型钢板进行RSL关节固定术（不使用舟骨远端切除术）。他们的平均年龄是43岁(范围，32-56).对患者进行影像学检查以评估其愈合情况，并在临床上评估其活动范围，握力,和疼痛（通过视觉模拟评分（VAS）评估疼痛）。通过使用Mayo改良腕部评分（MMWS）和手臂残疾进行功能评估，肩膀,手（DASH）问卷。
结果：所有患者在平均8.7周后在融合部位显示完全愈合（范围，8-12).平均随访时间为72个月(范围，60-84).捏合强度从6.2kg的平均值提高(范围，3-12)平均9.8公斤(范围，5-18），代表对侧的80％。平均捏合强度为7kg(范围，5-18），代表了另一面的80%。疼痛的VAS显示平均改善72.6%。DASH得分提高到平均19.2(范围，14-24).MMWS提高到平均值68(范围，45-86).在最后的随访期,腕关节中未见退行性改变。
结论：RSL关节固定术（使用锁定微型钢板，不使用舟骨远端切除术）是治疗桡骨远端骨折关节内不愈合后桡骨OA病例的可靠手术方法，具有良好的临床和放射学结果。
方法：IV级-治疗性。
