关节固定术作为掌指关节置换术失败后的挽救手术。

IF 1.8 Q2 ORTHOPEDICS HAND Pub Date : 2024-09-23 DOI:10.1177/15589447241279589
Matthew M Rode, Kitty Y Wu, Benjamin D Welling, Marco Rizzo
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引用次数: 0

摘要

背景:掌指关节(MCP)假体植入失败的手术治疗包括翻修关节成形术和关节置换术。本研究的目的是回顾关节置换术作为 MCP 关节置换术失败后挽救手术的适应症和结果:这是一项回顾性队列研究,研究对象是1990年至2020年期间在一家医疗机构接受MCP关节置换术救治的所有患者。研究人员查阅了患者病历,了解了患者的人口统计学特征、救治指征、手术技术、翻修率和影像学结合时间。此外,还收集了患者报告的结果,包括密歇根手部结果问卷和 MCP 专项问卷,详细描述了疼痛、功能、外观和患者满意度:共纳入了 9 名患者(6 名女性,3 名男性,中位年龄为 66 岁)的 11 个手指,随访时间中位数为 36 个月。大多数患者(91%)还伴有软组织畸形,包括关节挛缩、伸展滞后和副韧带功能不全。关节置换术后的总体翻修率为45%,其中3位患者需要进行1次翻修,2位患者需要进行3次翻修。总体结合率为91%,从最近一次关节置换术算起,中位结合时间为4个月。4名患者的患者报告结果显示疼痛和功能有所改善:结论:尽管翻修率高达 45%,但根据 4 位患者的经验,关节置换术后的 MCP 节段置换术的最终结合率高达 91%,且疼痛和功能均有所改善。对于关节持续不稳定和功能受限的软组织畸形患者,应考虑采用关节置换术作为MCP关节置换失败后的挽救手术。
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Arthrodesis as Salvage for Failed Metacarpophalangeal Arthroplasty.

Background: Surgical management of failed metacarpophalangeal (MCP) arthroplasties includes revision arthroplasty and arthrodesis. The purpose of this study was to review the indications and outcomes of arthrodesis as a salvage procedure for failed MCP arthroplasties.

Methods: This was a retrospective cohort study of all patients undergoing salvage MCP arthrodesis at a single institution from 1990 to 2020. Patient charts were reviewed for patient demographics, indication for salvage, surgical technique, revision rate, and time to radiographic union. Patient-reported outcomes, including the Michigan Hand Outcomes Questionnaire and an MCP-specific questionnaire detailing pain, functional, appearance, and patient satisfaction, were also collected.

Results: Eleven digits in 9 patients (6 women, 3 men, median age of 66) with median 36-month follow-up were included. The majority (91%) of patients also had concomitant soft tissue deformities, including joint contractures, extension lag, and collateral ligament insufficiency. The overall revision rate following arthrodesis was 45% with 3 digits requiring one revision each, and 2 digits undergoing 3 revisions. The overall union rate was 91% with median time to union of 4 months from most recent arthrodesis. Patient-reported outcomes obtained from 4 patients demonstrated improvements in pain and function.

Conclusion: Despite a high revision rate of 45%, salvage MCP arthrodesis following arthroplasty has a high eventual union rate of 91% and is associated with improved pain and function based on 4 patients' experiences. Arthrodesis as a salvage procedure for failed MCP arthroplasties should be considered in patients with persistent joint instability and functionally limiting soft tissue deformities.

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来源期刊
HAND
HAND Medicine-Surgery
CiteScore
3.30
自引率
0.00%
发文量
209
期刊介绍: HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.
期刊最新文献
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