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Nonunion after trapeziometacarpal arthrodesis: comparison between K-wire and internal fixation

机译:梯形掌骨关节融合术后不愈合:克氏针与内固定的比较

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We reviewed 63 trapeziometacarpal arthrodeses (57 patients performed in our unit between April 2007 and May 2013 for osteoarthritis. K-wires, plates, headless compression screws and memory staples were used for fixation. The average age of patients was 50 (range 20-78) years and there were 36 men and 21 women with a mean follow-up of 36 (range 6-62) months. K-wires were used in 31 cases, staples in 12, plates in five, and screws in 15 joints. The overall non-union rate was 11, however, when using K-wires for fixation, it was 20. Union was achieved in all cases when staples or screws were used for fixation. Disabilities of the Arm, Shoulder and Hand scores were higher in cases where non-union occurred compared with those that united (66.7 vs. 21.9). Trapeziometacarpal arthrodesis for osteoarthritis gives good clinical outcome with lower (DASH) scores when union occurs. K-wire fixation led to a 20 non-union rate, and as a result, the senior author no longer uses this method of fixation.
机译:我们回顾了 2007 年 4 月至 2013 年 5 月期间在我们单位进行的 63 例梯形掌骨关节融合术(57 例患者)的骨关节炎。使用克氏针、钢板、无头压缩螺钉和记忆钉进行固定。患者的平均年龄为 50 岁(范围 20-78 岁),男性 36 例,女性 21 例,平均随访时间为 36 个月(范围 6-62 个月)。31 例使用了 K 线,12 例使用了订书钉,5 例使用了板,15 个接头使用了螺钉。总体不愈合率为 11%,然而,当使用克氏针进行固定时,为 20%。在使用订书钉或螺钉进行固定的所有情况下都实现了结合。与联合病例相比,发生不愈合的手臂、肩部和手部残疾得分更高(66.7 对 21.9)。骨关节炎的梯形掌骨关节融合术具有良好的临床结果,当愈合发生时 (DASH) 评分较低。克氏针固定导致20%的不愈合率,因此,资深作者不再使用这种固定方法。

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