期刊
JOURNAL OF HAND SURGERY-AMERICAN VOLUME
卷 39, 期 12, 页码 2424-2433出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jhsa.2014.09.005
关键词
Proximal row carpectomy; 4-corner fusion; arthrodesis; range of motion
资金
- University Hospitals of Leicester NHS Trust Foxtrot Charity
- Federation of European Societies for Surgery of the Hand
- British Orthopaedic Association
- Fonds NutsOhra
Purpose To investigate the effect of 4-corner fusion (4CF) or proximal row carpectomy (PRC) on wrist motion, strength, and outcome for 2 different cohorts from 2 separate institutions performing either 4CF or PRC for stage 2/3 scaphoid nonunion advanced collapse and scapholunate advanced collapse. Methods The researchers assessed 46 subjects (24 4CF and 22 PRC), mean age 54 years, with a flexible electrogoniometer to measure maximum wrist motion and circumduction and compare it with the nonsurgical wrist. We analyzed the shape, size, rate, and smoothness of the circumduction curves. We assessed the maximum grip and sustainability of grip for 60 seconds using a digital grip analyzer. Patient evaluation measure and Michigan Hand Questionnaires measured patient-reported outcomes. Results Flexion-extension in the surgically treated wrist was 50% of the nonsurgical side after a 4CF and 65% after a PRC. The radioulnar deviation component in circumduction of the surgically treated wrist was similar but markedly decreased after either procedure. The mean area of circumduction of the surgically treated wrist was similar after a PRC and a 4CF but was 30% of the nonsurgical wrist. The center of the circumduction ellipse after a PRC was closer than after a 4CF to the opposite wrist. The orientation of the plane of circumduction was 22 degrees to the vertical flexion-extension plane after a PRC. After a 4CF, the plane was more vertical (9 degrees). The peak grip strength and the area under the force time curve was 80% of the nonsurgical side after a PRC and 60% after a 4CF. The Michigan Hand Questionnaire result was 90% of the score for the nonsurgical hand after a PRC and 75% of score for the nonsurgical hand after a 4CF. Conclusions The PRC provided improved flexion-extension with a circumduction curve concentric with the nonsurgical wrist. The 4CF limited extension and ulnar deviation more than did a PRC. (Copyright (C) 2014 by the American Society for Surgery of the Hand. All rights reserved.)
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据