Scaphoid Excision and Limited Wrist Fusion: A Comparison of K-Wire and Circular Plate Fixation

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• 作者：Jeffrey A. Rodgers (1)
  Gary Holt (2)
  Edward P. Finnerty (3)
  Blake Miller (3)
  
• 关键词：Wrist ; Arthritis ; Limited wrist arthrodesis
• 刊名：HAND
• 出版年：2008
• 出版时间：September 2008
• 年：2008
• 卷：3
• 期：3
• 页码：276-281
• 全文大小：122KB
• 参考文献：1. Chung KC, Watt AJ, Kotsis SV. A prospective outcomes study of four-corner wrist arthrodesis using a circular limited wrist fusion plate for stage II scapholunate advanced collapse wrist deformity. Plast Reconstr Surg 2006;118:433-2. CrossRef
  2. Dacho A, Grundel J, Holle G, Germann G, Sauerbier M. Long-term results of midcarpal arthrodesis in the treatment of scaphoid nonunion advanced collapse (SNAC-wrist) and scapholunate advanced collapse (SLAC-wrist). Ann Plast Surg 2006;56:139-4. CrossRef
  3. Garcia-Lopez A, Perez-Ubeda F, Molina M, Lopez-Duran L. A modified technique of four-bone fusion for advanced carpal collapse. J Hand Surg 2001;26B:352-.
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  10. Vance M, Hernandez JD, DiDonna ML, Stern PJ. Complications and outcome of four-corner arthrodesis: circular plate fixation versus traditional techniques. J Hand Surg 2005;30A:1122-.
  
• 作者单位：Jeffrey A. Rodgers (1)
  Gary Holt (2)
  Edward P. Finnerty (3)
  Blake Miller (3)
  
  1. Des Moines Orthopaedic Surgeons, P.C., 6001 Westown Parkway, West Des Moines, IA, 50266, USA
  2. Roseburg Radiologists, Roseburg, OR, 97470, USA
  3. Des Moines University, 3200 Grand Avenue, Des Moines, IA, 50312, USA
  

文摘

The purpose of this study was to compare the clinical outcome, union rate, and complications of a consecutive series of Scaphoid excision and limited wrist arthrodesis performed by a single surgeon using distal radius bone graft and K-wires or circular plate fixation. A sequential series of ten patients(11 wrists) who were stabilized with temporary K-wires were compared to 11 patients (11 wrists) who were stabilized with a circular plate. Minimum follow-up was 1?year. One patient in the K-wire group was converted to a wrist fusion. Six of the remaining ten patients in the K-wire fixation group and 8 of the 11 patients in the circular plate fixation group returned for the following blinded evaluations: Quick DASH, analog pain scale, range of motion, grip and pinch strength, plain x-ray, and multi-detector computed tomography evaluation. One non-union occurred in the K-wire group. There were no non-unions in the circular plate fixation group. There was no difference in any of remaining measures or rate of complications. This study shows that equivalent results can be obtained using circular plate fixation compared to K-wires when equivalent bone graft source and fusion technique are used. If K-wire removal requires a return to the OR, circular plate fixation is more cost-effective.