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MCP arthrodesis using an intramedullary interlocking device

机译:使用髓内互锁装置进行MCP关节固定

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Background A variety of metacarpophalangeal joint (MCPJ) arthrodesis techniques have been described for the treatment of symptomatic arthritis and instability of the thumb MCPJ including K wire fixation, tension-band arthrodesis, plate fixation, intramedullary screw, and other intramedullary devices. This study presents a retrospective review of one surgeon's initial series of patients undergoing thumb MCP arthrodesis using an intramedullary compression device with a fixed angle of 25°. Methods A retrospective chart and radiographic review of patients treated for thumb MCP arthrodesis using the intramedullary device was performed. Final radiographs were evaluated for arthrodesis angle, bony fusion, and implant fixation. Any complication found during surgery or the follow-up period was noted. Results In this study, 17 patients were reviewed. Indications for surgery were osteoarthritis (five patients), rheumatoid arthritis (three patients), MCP instability alone (seven patients), and post-traumatic conditions (two patients). Of these, 12 patients had a simultaneous trapeziometacarpal (TMC) soft tissue arthroplasty. Mean follow-up was 4.9?months. All 17 patients had clinical and radiographic evidence of fusion at an average of 7.9?weeks, with an average fusion angle of 24.4°. There were no hardware complications, no infections, no revisions, and no indications for hardware removal. Discussion Our study results indicate the technique promotes rapid union at a precise angle, provides strong fixation that does not require prolonged immobilization, does not cause hardware irritation, and can be used in conjunction with other procedures including TMC arthroplasty when MCP arthrodesis is indicated for joint instability.
机译:背景技术已描述了多种掌指关节(MCPJ)关节固定术技术,用于治疗症状性关节炎和拇指MCPJ不稳定,包括K线固定,张力带关节固定术,钢板固定,髓内螺钉和其他髓内装置。这项研究回顾性回顾了一个外科医生使用固定角度为25°的髓内压迫装置进行拇指MCP关节固定术的一系列患者。方法对使用髓内装置治疗拇指MCP关节固定术的患者进行回顾性检查并进行影像学检查。对最终的X射线照片进行关节固定角度,骨融合和植入物固定的评估。记录在手术或随访期间发现的任何并发症。结果本研究对17例患者进行了回顾。手术适应症为骨关节炎(5例),类风湿性关节炎(3例),仅MCP不稳定(7例)和创伤后状况(2例)。其中,有12例患者同时进行了棘足掌(TMC)软组织置换术。平均随访4.9个月。所有17例患者的临床和放射学证据均显示融合平均为7.9周,平均融合角为24.4°。没有硬件并发症,没有感染,没有修订,也没有硬件拆卸的迹象。讨论我们的研究结果表明,该技术可促进以精确的角度快速愈合,提供牢固的固定状态,不需要长时间的固定,不会引起硬件刺激,并且当指示MCP关节固定时,可与其他方法(包括TMC置换术)结合使用不稳定。

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