k -钢丝关节融合术治疗绝经后妇女第一腕掌关节病的结果

Kamil Yamak, H. Karahan, T. Altay, C. Kayalı, Fırat Ozan
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摘要

目的:研究的目的是评估关节融合术联合k线固定治疗绝经后妇女第一腕腕关节(CMC)伊顿iii期关节病的结果。方法:回顾性分析2011年1月至2019年1月期间接受治疗的患者。术前和随访后分别计算Quick-DASH评分。研究了直接造影的联合状态、随访结束时舟状斜方关节关节炎的存在以及掌跖指关节代偿性过伸的发展。随访结束时测量了手握力。结果:19例患者共21个关节融合术纳入研究。平均年龄56.6岁(52 ~ 72岁)。平均随访时间为57.7(17-90)个月。所有患者随访结束时的Quick-DASH评分与术前评分相比均有统计学意义的改善(p=0.001)。随访结束时直接造影显示8例患者中有9例关节融合术后不愈合(42.8%)。在一例关节融合术后未融合的患者中,进行了翻修手术(4.7%)。随访结束时,有无愈合患者的Quick-DASH评分差异无统计学意义(p=0.84)。融合与不愈合患者的握力差异无统计学意义(p=0.214)。结论:在我们的研究中,观察到第一CMC关节的k-钢丝关节融合术与高不愈合率相关,但不愈合并未对功能结果产生不利影响。我们认为,为了得到更精确的结果,需要进行大规模的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Results of arthrodesis with K-wire for the treatment of the first carpometacarpal joint arthrosis in postmenopausal women
Objectives: The aim of study was to evaluate the results of arthrodesis with K-wire fixation for the treatment of Eaton stage-III arthrosis of the first carpometacarpal (CMC) joint in postmenopausal women. Methods: Patients treated between January 2011 and January 2019 were evaluated retrospectively. Quick-DASH scores were calculated before surgery and after follow-up. Union status on direct graphy, the presence of scaphotrapeziotrapezoid joint arthritis at the end of follow-up and the development of compensatory hyperextension of the metocarpophalangeal joint were investigated. Hand grip strengths at the end of follow-up was measured. Results: A total of 21 joints with arthrodesis in 19 patients were included in the study. Mean age was 56.6(52-72) years. Mean follow-up period was 57.7(17-90) months. In all patients, there was statistically significant improvement in the end of follow-up Quick-DASH score when compared with the presurgical score (p=0.001). Direct graphy at the end of follow-up revealed that there was non-union after arthrodesis in nine joints of eight patients (42.8%). In one patient without fusion following arthrodesis, revision surgery was performed (4.7%). There was no significant difference between the end of fol - low-up Quick-DASH scores of patients with and without union(p=0.84). The difference in hand grip strength in patients with fusion and non-union wasn’t statistically significant (p=0.214). Conclusion: In our study, it was observed that k-wire arthrodesis of the first CMC joint was associated with high nonunion rates, but nonunion did not have an unfavourable effect on functional results.We believe that studies with large series are needed for a more precise result.
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