Abstract：
BACKGROUND: Four-corner arthrodesis with scaphoid excision (FCA) and proximal row carpal resection (PRC) are frequently performed in wrists with post-traumatic Scaphoid Non- Union Advanced Collapse (SNAC)/Scapho-Lunate Advanced Collapse (SLAC) osteoarthritis. The aim of this study was to compare the clinical outcomes of these two procedures.
METHODS: This single-center, retrospective cohort study included all patients who had PRC or FCA between January 1st, 2009 and January 1st, 2019 and who were followed up. Follow-up included: mobility (radial deviation, ulnar deviation, flexion, extension), strength (grip test, pinch test), function (QuickDash, patient-rated wrist evaluation [PRWE]), subjective mobility, and global satisfaction scores.
RESULTS: Among 25 patients included, 11 had PRC and 14 had FCA with a mean follow-up of 69.5 months [12-132]. Radial deviation was 18° versus 14° (p = 0.7), ulnar deviation was 21° versus 22° (p = 0.15), flexion was 39° versus 30° (p = 0.32), extension was 32.5° versus 29.5° (p = 0.09), grip test compared to the controlateral side was 72% versus 62% (p = 0.53), Quick Dash score was 12.5 versus 17.6 (p = 0.84), PRWE was 18.7 versus 17.6 (p = 0.38), subjective mobility was 7.8 versus 7.5 (p = 0.23), and satisfaction score was 8.7 versus 9 (p = 0.76), respectively, in the FCA group and the PRC group. Re-operation rates were 14% patients in the FCA group and 0% in the PRC group.
CONCLUSIONS: This study found no significant difference between FCA and PRC on strength, mobility, and function in patients with post-traumatic SLAC or SNAC stage II wrist arthritis. Both FCA and PRC seem to be reliable surgical techniques with good outcomes with more revision in the FCA group.
METHODS: This single-center, retrospective cohort study included all patients who had PRC or FCA between January 1st, 2009 and January 1st, 2019 and who were followed up. Follow-up included: mobility (radial deviation, ulnar deviation, flexion, extension), strength (grip test, pinch test), function (QuickDash, patient-rated wrist evaluation [PRWE]), subjective mobility, and global satisfaction scores.
RESULTS: Among 25 patients included, 11 had PRC and 14 had FCA with a mean follow-up of 69.5 months [12-132]. Radial deviation was 18° versus 14° (p = 0.7), ulnar deviation was 21° versus 22° (p = 0.15), flexion was 39° versus 30° (p = 0.32), extension was 32.5° versus 29.5° (p = 0.09), grip test compared to the controlateral side was 72% versus 62% (p = 0.53), Quick Dash score was 12.5 versus 17.6 (p = 0.84), PRWE was 18.7 versus 17.6 (p = 0.38), subjective mobility was 7.8 versus 7.5 (p = 0.23), and satisfaction score was 8.7 versus 9 (p = 0.76), respectively, in the FCA group and the PRC group. Re-operation rates were 14% patients in the FCA group and 0% in the PRC group.
CONCLUSIONS: This study found no significant difference between FCA and PRC on strength, mobility, and function in patients with post-traumatic SLAC or SNAC stage II wrist arthritis. Both FCA and PRC seem to be reliable surgical techniques with good outcomes with more revision in the FCA group.
摘要：
背景：四角关节固定术伴舟骨切除术（FCA）和近端行腕骨切除术（PRC）经常在创伤后舟骨非联盟晚期塌陷（SNAC）/Scapho-Lumate晚期塌陷（SLAC）的腕关节中进行。这项研究的目的是比较这两种方法的临床结果。
方法：这种单中心，回顾性队列研究包括所有在1月1日之间有PRC或FCA的患者，2009年1月1日,2019年和谁被跟进。随访包括：流动性(径向偏差，尺位偏差,屈曲，扩展),强度(抓地力测试，夹紧试验),函数(QuickDash,患者腕部评估[PRWE])，主观流动性，和全球满意度得分。
结果：在25名患者中，11人患有PRC，14人患有FCA，平均随访69.5个月[12-132]。径向偏差为18°对14°（p=0.7），尺骨偏差为21°对22°（p=0.15），屈曲为39°对30°（p=0.32），延伸为32.5°对29.5°（p=0.09），与对照侧相比，抓地力测试为72%对62%(p=0.53)，快速冲刺得分为12.5对17.6（p=0.84），PRWE为18.7对17.6（p=0.38），主观流动性为7.8对7.5(p=0.23)，满意度得分为8.7和9(p=0.76)，分别,在FCA组和PRC组中。FCA组为14%，PRC组为0%。
结论：这项研究发现FCA和PRC在强度上没有显着差异，移动性,创伤后SLAC或SNACII期腕关节炎患者的功能。FCA和PRC似乎都是可靠的手术技术，在FCA组中有更多的修正，效果良好。
方法：这种单中心，回顾性队列研究包括所有在1月1日之间有PRC或FCA的患者，2009年1月1日,2019年和谁被跟进。随访包括：流动性(径向偏差，尺位偏差,屈曲，扩展),强度(抓地力测试，夹紧试验),函数(QuickDash,患者腕部评估[PRWE])，主观流动性，和全球满意度得分。
结果：在25名患者中，11人患有PRC，14人患有FCA，平均随访69.5个月[12-132]。径向偏差为18°对14°（p=0.7），尺骨偏差为21°对22°（p=0.15），屈曲为39°对30°（p=0.32），延伸为32.5°对29.5°（p=0.09），与对照侧相比，抓地力测试为72%对62%(p=0.53)，快速冲刺得分为12.5对17.6（p=0.84），PRWE为18.7对17.6（p=0.38），主观流动性为7.8对7.5(p=0.23)，满意度得分为8.7和9(p=0.76)，分别,在FCA组和PRC组中。FCA组为14%，PRC组为0%。
结论：这项研究发现FCA和PRC在强度上没有显着差异，移动性,创伤后SLAC或SNACII期腕关节炎患者的功能。FCA和PRC似乎都是可靠的手术技术，在FCA组中有更多的修正，效果良好。
