Clinical Outcomes of Lunocapitate Arthrodesis: A Retrograde Single-Screw Approach.

IF 1.8 Q2 ORTHOPEDICS

HAND Pub Date : 2024-11-01 Epub Date: 2023-05-27 DOI:10.1177/15589447231174041

Ather Mirza, Justin B Mirza, Luke C Zappia, Terence L Thomas, Jagger Corabi, Zachary Dusckas, John D Lubahn

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引用次数: 0

Abstract

Background: A single-site retrospective study was designed to evaluate the clinical outcomes of single-screw lunocapitate arthrodesis (LCA) using a retrograde approach for the treatment of scapholunate advanced collapse (SLAC) wrist.

Methods: We retrospectively identified 31 patients (33 cases) between September 2010 and December 2019 with SLAC wrist changes who were treated with single-screw LCA. Objective outcomes included time to fusion, union rate, range of motion, and grip and pinch strength recovery. Subjective outcomes included Disabilities of the Arm, Shoulder, and Hand (DASH) scores.

Results: We report on 33 cases (7 female), mean age 58.4 years (range: 41-85), with SLAC wrist who underwent LCA. Our cohort reported a 94% union rate and a 90-day mean time to fusion. Final active wrist range of motion was 38° dorsiflexion, 35° volarflexion, 17° radial deviation, 17° ulnar deviation, 82° pronation, and 83° supination (mean: 450.8 days). Final grip and pinch strengths recovered was 75% gross grip, 84% lateral pinch, and 75% precision pinch (mean: 379.0 days) compared with the contralateral side. The mean postoperative DASH score was 27 (mean: 1203.9 days). Two nonunions were observed. Two hardware complications occurred: one symptomatic screw and one screw fatigue fracture.

Conclusions: We found retrograde single-screw LCA to be an effective salvage procedure for SLAC wrist. LCA is a less-taxing procedure, requires shorter operating time, and produces range of motion and grip and pinch strength recovery comparable to those of 4-corner arthrodesis. Furthermore, the viability of single-screw fixation may reduce hardware-related operative costs without compromising union rates.

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月骨关节置换术的临床效果：逆行单螺钉方法

背景：我们设计了一项单病例回顾性研究，以评估采用逆行方法进行单螺钉月状关节置换术（LCA）治疗肩胛骨晚期塌陷（SLAC）腕关节的临床效果：我们回顾性地确定了2010年9月至2019年12月期间接受单螺钉LCA治疗的31例SLAC腕关节病变患者（33例）。客观结果包括融合时间、结合率、活动范围、握力和夹力恢复情况。主观结果包括手臂、肩部和手部残疾（DASH）评分：我们报告了 33 例接受 LCA 的 SLAC 腕关节病例（7 例女性），平均年龄 58.4 岁（41-85 岁）。我们的队列报告了94%的结合率和90天的平均融合时间。最终的腕关节活动范围为：外翻 38°、外展 35°、桡侧偏斜 17°、尺侧偏斜 17°、前倾 82°、后仰 83°（平均：450.8 天）。与对侧相比，最终恢复的握力和捏力为：粗握 75%、侧捏 84%、精确捏 75%（平均：379.0 天）。术后 DASH 评分平均为 27 分（平均：1203.9 天）。观察到两处不榫接。出现了两种硬件并发症：一种是螺钉无症状，一种是螺钉疲劳断裂：我们发现逆行单螺钉 LCA 是一种有效的 SLAC 腕关节挽救手术。逆行单螺钉腕关节置换术是一种有效的腕关节SLAC抢救方法，手术创伤小，手术时间短，活动范围、握力和捏力的恢复与四角关节置换术相当。此外，单螺钉固定的可行性可能会降低与硬件相关的手术成本，而不影响结合率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HAND Medicine-Surgery

CiteScore

3.30

自引率

0.00%

发文量

209

期刊介绍： HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.