| Objective To compare the clinical efficacy of the NiTi shape memory ally four-corner arthrodesis concentrator NT-MFCAC before and after modification for the treatment of navicular malunion wrist collapse via dorsal wrist approach.Methods The clinical data of 56 patients with navicular malunion wrist collapse who underwent surgical treatment in the 920th Hospital of the People's Liberation Army Joint Logistic Support Force from May 2009 to May 2022 were retrospectively analyzed, of which 26 cases underwent fixation with a modified anterior four-corner arthrodesis concentrator (the pre-modified group), and 30 cases underwent fixation with a modified posterior four-corner arthrodesis concentrator (the post-modified group). The operative time, intraoperative bleeding, time to bone fusion, complication rate, and Quick Arm Shoulder Hand Dysfunction Score (Quick DASH) at preoperative, 6 months, 12 months, and final follow-up and wrist range of motion (ROM) at final follow-up were compared between the two groups.Results All 56 cases were followed up for 24-60 months, with a mean time of (40.02±7.97) months. There was no statistically significant difference between the two groups in terms of mean operative time, intraoperative bleeding and carpal fusion time (P>0.05). The Quick DASH scores of the two groups at the final follow-up were significantly better than those at 6 and 12 months after surgery, and the difference was statistically significant (P<0.05). There was no significant difference in wrist ROM at the final follow-up, and the difference was not statistically significant (P>0.05). During the follow-up period, the modified group had 1 case of complication, which was significantly lower than the 3 cases in the unmodified group. However, when comparing the complication rates between the two groups, the difference was not statistically significant (P>0.05). No complications such as incision infection and bone nonunion occurred in either groups during the follow-up period.Conclusion Both types of carpal fusion devices achieved good efficacy in the treatment of navicular malunion wrist collapse, while the modified skeletonized quadrangular fusion device has the advantages of fewer complications and convenient observation of bone fusion, making it an effective method choice for the treatment of navicular malunion wrist collapse. |
