Reliability of the 8 Week Time Point for Single Assessment of Midcarpal Fusion by CT Scan
Tóm tắt
High rates of nonunion have recently been reported for midcarpal fusions. Due to curvature and overlap of carpal interfaces, two dimensional films are not reliable in determining union of a midcarpal fusion. Computed tomography is the most reliable radiographic method of evaluating osseous union. Initiating motion as soon as fusion has occurred is a priority with the goal of maximizing final range. Cost control in healthcare makes obtaining serial scans unreasonable. The single optimal time point for a computed tomography scan to determine union of a midcarpal fusion remains to be determined. A prospective protocol selected 8 weeks post operative as the point in time to obtain the single determining scan. Forty-six consecutive midcarpal fusions with scaphoidectomy were retrospectively analyzed for the reliability of this time point. All fusions had achieved union by 8 weeks and only this one scan was clinically necessary to advance the patients on to full range of motion without a splint at that time.
Tài liệu tham khảo
Calandruccio JH, Gelberman RH, Duncan SF et al (2000) Capitolunate arthrodesis with scaphoid and triquetrum excision. J Hand Surg Am 25:824–832
Chung KC, Watt AJ, Kotsis SV (2006) A prospective outcomes study of four-corner wrist arthrodesis using a circular limited wrist fusion plate for stage II scapholunate advanced collapse wrist deformity. Plast Reconstr Surg 118:433–442
Dacho A, Grundel J, Holle G et al (2006) Long-term results of midcarpal arthrodesis in the treatment of scaphoid nonunion advanced collapse (SNAC-wrist) and scapholunate advanced collapse (SLAC-wrist). Ann Plast Surg 56:139–144
Sauerbier M, Trankle M, Linsner G et al (2000) Midcarpal arthrodesis with complete scaphoid excision and interposition bone graft in the treatment of advanced carpal collapse (SNAC/SLAC wrist): operative technique and outcome assessment. J Hand Surg Br 25:341–345
Merrell GA, McDermott EM, Weiss AP (2008) Four-corner arthrodesis using a circular plate and distal radius bone grafting: a consecutive case series. J Hand Surg Am 33:635–642
Shindle MK, Burton KJ, Weiland AJ et al (2007) Complications of circular plate fixation for four-corner arthrodesis. J Hand Surg Eur 32:50–53
Vance MC, Hernandez JD, Didonna ML et al (2005) Complications and outcome of four-corner arthrodesis: circular plate fixation versus traditional techniques. J Hand Surg Am 30:1122–1127
Cohen MS, Kozin SH (2001) Degenerative arthritis of the wrist: proximal row carpectomy versus scaphoid excision and four-corner arthrodesis. J Hand Surg Am 26:94–104
Dacho AK, Baumeister S, Germann G (2008) Comparison of proximal row carpectomy and midcarpal arthrodesis for the treatment of scaphoid nonunion advanced collapse (SNAC-wrist) and scapholunate advanced collapse (SLAC-wrist) in stage II. J Plast Reconstr Aesthet Surg 61:1210–1218
Wyrick JD, Stern PJ, Kiefhaber TR (1995) Motion-preserving procedures in the treatment of scapholunate advanced collapse wrist: proximal row carpectomy versus four-corner arthrodesis. J Hand Surg Am 20:965–970
Ekelund L, Hagberg L, Horberg L et al (2007) Imaging of four-corner fusion (SLAC arthrodesis) of the wrist with 64-slice computed tomography. Acta Radiol 48:76–79
Mantovani G, Mathoulin C, Fukushima WY et al (2010) Four corner arthrodesis limited to the centre using a scaphoid one piece graft and a dorsal circular plate. J Hand Surg Eu 35:38–42
El-Mowafi H, El-Hadidi M, Boghdady GW et al (2007) Functional outcome of four-corner arthrodesis for treatment of grade IV scaphoid non-union. Acta Orthop Belg 73:604–611
Kirschenbaum D, Schneider LH, Kirkpatrick WH et al (1993) Scaphoid excision and capitolunate arthrodesis for radioscaphoid arthritis. J Hand Surg Am 18:780–785
Gupta RK, Chauhan DS, Singh H (2010) Non-union scaphoid: four-corner fusion of the wrist. Indian J Orthop 44:208–211
Goubier JN, Teboul F (2007) Capitolunate arthrodesis with compression screws. Tech Hand Up Extrem Surg 11:24–28
Rodgers JA, Holt G, Finnerty EP (2008) Scaphoid excision and limited wrist fusion: a comparison of K-wire and circular plate fixation. Hand 3:276–281
Ronchetti PJ, Topper SM (2006) Lunocapitate fusion using the OSStaple compression staple. Tech Hand Up Extrem Surg 10:231–234
Van Riet RP, Bain GI (2006) Three-corner wrist fusion using memory staples. Tech Hand Up Extrem Surg 10:259–264
Gaston RG, Greenberg JA, Baltera RM et al (2009) Clinical outcomes of scaphoid and triquetral excision with capitolunate arthrodesis versus scaphoid excision and four-corner arthrodesis. J Hand Surg Am 34:1407–1412