腕关节融合钢板内固定术的临床疗效

Clinical outcomes of wrist arthrodeses with wrist fusion plate

目的评价腕关节融合钢板内固定术的临床疗效。方法2000年7月—2004年12月,采用腕关节融合钢板内固定术治疗创伤性腕关节炎21例。随访内容包括腕关节疼痛程度、手指关节活动度、握力和X线片。根据Buck-Gramcko/Lohmannn评分表评价腕关节总体功能,DASH调查表评价腕关节融合术对患者日常活动及生活质量的影响。结果术后21例获得随访,平均随访时间为20个月。术后患侧腕部疼痛值平均为1．5(术前4．5),12例掌指关节和10例拇指指间关节出现轻微背伸功能障碍,腕部握力为30 kg(健侧为38 kg)。X线片示腕关节全部骨性融合。Buck-Gramcko/Lohmannn评分值为8．7,其中优5例、良10例,中6例。DASH值为32,DASH调查表结果表明腕关节融合术后部分日常活动受限。结论腕关节融合钢板内固定成功率高,腕关节疼痛明显减轻,但术后腕关节部分功能丧失。

Objective The purpose of this study was to evaluate the effectiveness of wrist arthrodeses with wrist fusion plate. Methods From July 1997 to December 2004, a total of 21 cases of traumatic arthrosis of the wrist were treated by arthrodeses with the wrist fusion plate. Wrist pain, range of motion of the fingers, grip strength, and X-rays were evaluated. The overall wrist function was graded according to Buck-Gramcko and Lohmann score. The effect of the operation on patient＇ s daily activities and general postoperative quality of life was evaluated with DASH-questionnaire. Results 21 cases had sufficient follow-up. The average follow-up time was 20 months. Mean pain scores was 1.5 postoperatively as compared to 4.5 pre-operatively. Slight extension deficit at MP joint of the fingers was seen in 12 cases, while thumb IP joint extension lag was observed in 10 eases. The average grip strength was 30 kg as compared to 38 kg of the opposite side. The radiological fusion rate was 100%. Buck-Grarneko and Lohmann score for functional evaluation averaged 8.7. 5 eases were graded as excellent, 10 eases as good, and 6 eases as fair. The value of DASH- questionnaire was 32, indicating that patients had difficulty with some activities. Conclusion Wrist arthrodesis with fusion plate is a reliable procedttre with a high success rate and good pain relief. Wrist function however, is limited to certain extent.