镍钛记忆合金腕骨四角融合器应用于腕塌陷临床疗效:9~10年随访

齐保闯, 蔡兴博, 宋慕国, 孟晨, 罗欢, 李川, 徐永清

中国临床解剖学杂志 ›› 2024, Vol. 42 ›› Issue (3) : 304-309.

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中国临床解剖学杂志 ›› 2024, Vol. 42 ›› Issue (3) : 304-309. DOI: 10.13418/j.issn.1001-165x.2024.3.10
临床研究

镍钛记忆合金腕骨四角融合器应用于腕塌陷临床疗效:9~10年随访

  • 齐保闯1,2,    蔡兴博1,    宋慕国1,    孟晨1,2,    罗欢1,2,    李川1,    徐永清1*
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Clinical efficacy of four-corner arthrodesis concentrator of nickel-titanium memory alloy for carpal collapse: 9-10 years of follow-up 

  • Qi Baochuang1,2, Cai Xingbo1, Song Muguo1, Meng Chen1,2, Luo Huan1,2, Li Chuan1, Xu Yongqing1*
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摘要

目的    探讨镍钛记忆合金腕骨四角融合器(NiTi shape memory ally four-corner arthrodesis concentrator,NT-FCAC)在治疗腕塌陷的应用效果,报告9~10年随访疗效。  方法    选取32例因舟骨骨不连腕塌陷及舟月进行性腕塌陷应用NT-FCAC行四角融合并舟骨切除术治疗的患者,采用测角计测量腕关节活动度;Jammar测力计测量握力;术前及术后进行快速臂肩手功能障碍评分(Quick DASH)观察肢体功能恢复情况;疼痛视觉模拟评分(VAS)评估患者腕关节疼痛程度,腕关节前后位及侧位片观察腕骨融合率。  结果    术后3个月32例腕骨均获骨性愈合。随访9~10年,所有患者未出现严重手术并发症,腕关节活动范围达到健侧的60%以上,患手握力恢复至健侧的80.78%。VAS评分由术前(5.97±0.86)分减至末次随访(0.16±0.37)分;Quick DASH评分由术前(70.00±4.76)分降至末次随访(6.16±1.25)分。VAS及Quick DASH评分术前较术后各次随访均具有统计学差异(P<0.05)。  结论    应用NT-FCAC进行腕骨四角融合术,腕骨融合率高,能保存大部分腕关节功能,远期疗效好,适用于需四角融合的腕塌陷。

Abstract

 Objective   To explore the application effect of NiTi shape memory ally four-corner arthrodesis concentrator (NT-FCAC) in the treatment of wrist collapse, and to report the efficacy of 9-10 years follow-up.    Methods    Thirty-two patients with four-corner arthrodesis and navicular osteotomy with NT-FCAC were selected for treatment of wrist collapse due to navicular osteogenesis imperfecta and navicular-moon-progressive wrist collapse. Goniometer was used to measure the wrist joint mobility. Jammar dynamometer was used to measure the grip strength. Quick DASH (Quick Arm, Shoulder, Hand Dysfunction Score) was used to observe the recovery of the limb function before and after the operation, and Visual Analogue Score (VAS) was used to assess the degree of the patients' wrist pain. Anteroposterior and lateral radiographs of the wrist joint were taken to observe the rate of carpal arthrodesis.    Results   Bone healing was obtained in all 32 carpal bones at 3 months postoperatively. At 9-10 years of follow-up, all patients had no serious surgical complications, the range of motion of the wrist joint reached more than 60% of the healthy side, and the grip strength of the affected hand was restored to 80.78% of that of the healthy side. The VAS score was reduced from the preoperative score (5.97±0.86) to the final follow-up (0.16±0.37), the Quick DASH score was reduced from the preoperative score (70.00±4.76) to the final follow-up (6.16±0.37). There were statistical differences in the preoperative  VAS and Quick DASH scores and  the VAS and Quick DASH scores at each follow-up.    Conclusions    The application of NT-FCAC for four-corner arthrodesis of the carpal bones has a high rate of carpal fusion, preserves most of the functions of the carpal joints, and has a good long-term efficacy, which is suitable for carpal collapse that requires four-corner arthrodesis.

关键词

腕;  /   / 腕塌陷;  /   / 四角融合术

Key words

Wrist;  /   / Carpal collapse;  /   / Four-corner arthrodesis

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导出引用
齐保闯, 蔡兴博, 宋慕国, 孟晨, 罗欢, 李川, 徐永清. 镍钛记忆合金腕骨四角融合器应用于腕塌陷临床疗效:9~10年随访[J]. 中国临床解剖学杂志. 2024, 42(3): 304-309 https://doi.org/10.13418/j.issn.1001-165x.2024.3.10
Qi Baochuang, Cai Xingbo, Song Muguo, Meng Chen, Luo Huan, Li Chuan, Xu Yongqing. Clinical efficacy of four-corner arthrodesis concentrator of nickel-titanium memory alloy for carpal collapse: 9-10 years of follow-up [J]. Chinese Journal of Clinical Anatomy. 2024, 42(3): 304-309 https://doi.org/10.13418/j.issn.1001-165x.2024.3.10
中图分类号: R658.2    

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基金

云南省骨科与运动康复临床医学研究中心(202102 AA310068);云南省创伤骨科临床医学中心(ZX20191001);全军临床重点专科建设项目;联勤医学重点专科项目

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