研究使用新型内固定器融合舟骨和大小多角骨

Use of a new fusion apparatus for scaphotrapeziotrapezoid arthrodesis

目的研究新型舟骨和大小多角骨融合器的应用效果。方法根据所测国人舟骨、大小多角骨和舟骨、大小多角骨关节有关解剖学参数设计，选用镍钛记忆合金制出样品，利用大型有限元分析软件进行生物力学测试，修改后制作出成品，并将其应用于月骨无菌性坏死及舟骨旋转性半脱位的患者。结果2005--2010年，共30例月骨无菌性坏死及舟骨旋转性半脱位患者术后疼痛消失或者缓解，运动度较术前增加，平均握力为44．4kg，达到健侧的77％。结论镂空式镍钛记忆合金融合器进行舟骨和大小多角骨融合技术，可以提供足够的腕骨间固定强度，有效用于腕骨间融合。

Objective To research arthrodesis of scaphotrapeziotrapezoid joints using a new designed fusion apparatus. Methods The fusion apparatus was designed based on the measurements of the wrist bones of the Chinese people with assistant of three-dimensional computed tomography （CT） image reconstruction. The apparatus was made of nickel-titanium （NiTi） shape memory alloy. The apparatus was reshaped after biomechanical test using the large-scale finite element analysis software. Results 2005-2010, 30 lunate aseptic necrosis and scaphoid rotational subluxation disappeared or alleviated pain after scaphotrapeziotrapezoid arthrodesis（STTA） and the movement was increased.The average grip was 44.4 kg. Conclusion Using of the HNT-STTAC for caphotrapeziotrapezoid arthrodesis is a usefixl technique that provides sufficient stability of the wrist bone fusion.