Complications of trapeziometacarpal arthrodesis using plate and screw fixation.
Complications of trapeziometacarpal arthrodesis using plate and screw fixation.
复制标题
使用板和螺钉固定的斜方掌关节融合术的并发症。
DOI：
10.1053/jhsu.2003.50042
复制
发表时间：
2003
期刊：
影响因子：
--
通讯作者：
P. Stern
中科院分区：
文献类型：
--
作者：
M. Forseth;P. Stern
目的
本研究旨在确定拇指腕掌关节融合术钢板螺钉固定相关的并发症，并将这些结果与本机构使用克氏针固定的既往报告进行比较。
方法
我们回顾性分析了26例使用钢板螺钉固定的腕掌关节融合术。最常见的诊断是原发性骨关节炎，平均随访评估为40个月。19例患者可进行临床随访检查和X线片检查。这些结果与之前发表的克氏针固定组进行了比较，后者包括59例关节融合术，平均随访期为84个月。
结果
有2例（8%）疼痛性骨不连。有6例（23%）内固定器械错位，最常见的与椎小斜方关节内的螺钉相关。7例（27%）关节融合术进行了第二次手术，最常见的是硬件取出。21例（81%）患者满意，并报告他们将再次进行关节融合术。在克氏针固定组中，59例关节融合术中有4例（7%）发生骨不连，59例中有2例需要二次手术;患者满意度较高（98%）。
结论
克氏针、钢板和螺钉固定的愈合率相当。然而，钢板螺钉固定组的满意率较低，二次手术更常见。我们现在建议在进行掌指关节融合术时使用针固定。
PURPOSE
This study was designed to determine the complications associated with plate and screw fixation of thumb trapeziometacarpal arthrodesis and to compare these results with a previous report from our institution using K-wire fixation.
METHOD
We retrospectively reviewed 26 trapeziometacarpal arthrodeses that used plate and screw fixation. The most common diagnosis was primary osteoarthritis and the average follow-up evaluation was 40 months. Nineteen patients were available for a clinical follow-up examination and radiographs. These results were compared with the previously published K-wire fixation group that consisted of 59 arthrodeses with an average follow-up period of 84 months.
RESULTS
There were 2 (8%) painful nonunions. There were 6 (23%) hardware malpositions, most frequently associated with a screw in the trapeziotrapezoid joint. Seven (27%) arthrodeses had a second procedure, most commonly hardware removal. Twenty-one (81%) of the patients were satisfied and reported they would have arthrodesis again. In the K-wire fixation group 4 of 59 (7%) arthrodeses went on to nonunion and 2 of 59 required a secondary procedure; patient satisfaction was high (98%).
CONCLUSIONS
K-wire and plate and screw fixation have comparable union rates. In the plate and screw fixation group, however, the satisfaction rate was lower and a second surgery was more common. We now recommend pin fixation when performing trapeziometacarpal joint arthrodesis.