Abstract：
OBJECTIVE: This study aimed to assess clinical, functional and radiological outcomes after three-corner arthrodesis in patients suffering from symptomatic scapholunate or scaphoid non-union advanced collapsed wrists. We hypothesised that three-corner arthrodesis provided satisfactory clinical and radiological results in the long term.
METHODS: This was a retrospective study of 13 patients (14 wrists) who underwent a three-corner arthrodesis between March 2004 and January 2019 with a mean follow-up of 6,7 years. Clinical assessment consisted of wrist motion, grip strength, pain and functional scores (Quick-DASH, PRWE, MWS). All complications and surgical revisions were investigated. Radiographic assessment searched for union, evaluated carpal height and ulnar translation, lunate tilt and occurrence of radio-lunate arthritis.
RESULTS: At the last follow-up Quick-DASH and PRWE scores were 24,87(± 17.2) and 47.4 (± 26.9) respectively and were significantly improved. Wrist motion was 35°, 32°, 10° et 24° of flexion, extension, radial and ulnar deviation respectively. Union was obtained for 13 (92,9%) wrists. The mean radiolunate angle was 11° (-17°-34°). Three patients needed reintervention, which 2 consisted of total wrist arthrodesis due to persisting pain. Mild signs of radio-lunate arthritis were found in three patients.
CONCLUSIONS: Three-corner arthrodesis seemed to provide satisfactory long-term functional outcomes. The union rate was high and even patients with signs of radio-lunate arthritis still had improved outcomes at the last follow-up. It could be a part of surgical options in wrists with radio- and midcarpal arthritis, among other procedures.
METHODS: This was a retrospective study of 13 patients (14 wrists) who underwent a three-corner arthrodesis between March 2004 and January 2019 with a mean follow-up of 6,7 years. Clinical assessment consisted of wrist motion, grip strength, pain and functional scores (Quick-DASH, PRWE, MWS). All complications and surgical revisions were investigated. Radiographic assessment searched for union, evaluated carpal height and ulnar translation, lunate tilt and occurrence of radio-lunate arthritis.
RESULTS: At the last follow-up Quick-DASH and PRWE scores were 24,87(± 17.2) and 47.4 (± 26.9) respectively and were significantly improved. Wrist motion was 35°, 32°, 10° et 24° of flexion, extension, radial and ulnar deviation respectively. Union was obtained for 13 (92,9%) wrists. The mean radiolunate angle was 11° (-17°-34°). Three patients needed reintervention, which 2 consisted of total wrist arthrodesis due to persisting pain. Mild signs of radio-lunate arthritis were found in three patients.
CONCLUSIONS: Three-corner arthrodesis seemed to provide satisfactory long-term functional outcomes. The union rate was high and even patients with signs of radio-lunate arthritis still had improved outcomes at the last follow-up. It could be a part of surgical options in wrists with radio- and midcarpal arthritis, among other procedures.
摘要：
目的：本研究旨在评估临床，有症状的肩胛骨或舟骨骨不连的患者行三角关节固定术后的功能和放射学结果。我们假设从长远来看，三角关节固定术可提供令人满意的临床和放射学结果。
方法：这是一项回顾性研究，对2004年3月至2019年1月期间接受三角关节固定术的13例患者（14例腕部）进行了回顾性研究，平均随访6,7年。临床评估包括腕关节运动，握力,疼痛和功能评分(Quick-DASH，PRWE,MWS）。调查了所有并发症和手术翻修。射线照相评估寻找联合，评估腕骨高度和尺骨平移，月球倾斜和放射性月关节炎的发生。
结果：末次随访时，Quick-DASH和PRWE评分分别为24,87（±17.2）和47.4（±26.9），均有明显改善。手腕运动35°,32°,10°到24°的屈曲，扩展,分别为径向和尺骨偏差。获得了13个（92,9％）手腕的联盟。平均放射状角度为11°(-17°-34°)。三名患者需要再次干预，其中2包括由于持续疼痛引起的全腕关节固定术。在三名患者中发现了轻度的放射状关节炎。
结论：三角关节固定术似乎提供了令人满意的长期功能结果。愈合率很高，甚至有放射性月行关节炎症状的患者在最后一次随访时仍有改善的结果。这可能是患有放射性和中腕关节炎的手腕手术选择的一部分，在其他程序中。
方法：这是一项回顾性研究，对2004年3月至2019年1月期间接受三角关节固定术的13例患者（14例腕部）进行了回顾性研究，平均随访6,7年。临床评估包括腕关节运动，握力,疼痛和功能评分(Quick-DASH，PRWE,MWS）。调查了所有并发症和手术翻修。射线照相评估寻找联合，评估腕骨高度和尺骨平移，月球倾斜和放射性月关节炎的发生。
结果：末次随访时，Quick-DASH和PRWE评分分别为24,87（±17.2）和47.4（±26.9），均有明显改善。手腕运动35°,32°,10°到24°的屈曲，扩展,分别为径向和尺骨偏差。获得了13个（92,9％）手腕的联盟。平均放射状角度为11°(-17°-34°)。三名患者需要再次干预，其中2包括由于持续疼痛引起的全腕关节固定术。在三名患者中发现了轻度的放射状关节炎。
结论：三角关节固定术似乎提供了令人满意的长期功能结果。愈合率很高，甚至有放射性月行关节炎症状的患者在最后一次随访时仍有改善的结果。这可能是患有放射性和中腕关节炎的手腕手术选择的一部分，在其他程序中。
