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· DOS Abstracts
Superior Healing in Small Joint Fusion in the Hand Us-
ing the Acutrak 2 Headless Compression Screw as Com-
pared to Kirschner Wires
Jens-Christian Vedel, Rasmus Wejnold Jørgensen, Claus Hjorth Jensen
Ortopædkirurgisk afdeling, Herlev & Gentofte
Background:
Various methods for arthrodesis in the small joints of the hand are
described and no single method has proven superior.
Purpose / Aim of Study:
The purpose of this study was to assess healing
and complication rate after arthrodesis of the distal interphalangeal joint or the
thumb interphalangeal joint using the Acutrak 2 headless compression screw or
Kirschner wires.
Materials and Methods:
We retrospectively analyzed 147 consecutive prima-
ry fusions performed with the Acutrak 2 headless compression screw (n=107)
or Kirschner wires (n=40) in 139 patients. Healing was assessed clinically and
radiographically at 6 to 8 weeks postoperatively. Follow-up was 12 months.
Findings / Results:
In 95 of 107 cases, healing occurred at 6 to 8 weeks
postoperatively following arthrodesis using the Acutrak 2 headless compres-
sion screw. Seven cases healed after 8 weeks. Secondary surgery with screw
removal was required in 11 cases. In five cases, the screw was removed due to
prominence of the screw, in two cases due to infection, and in four cases be-
cause of nonunion. In 29 of 39 cases, fusion had occurred at 6 to 8 weeks post-
operatively following arthrodesis using Kirschner wires showing a lower fusion
rate at this stage as compared to the Acutrak 2 headless compression screw
group (Chi-square = 9.5, p<0.01). Another eight joints in the K-wire group
fused at some point after 8 weeks of follow-up yielding a total fusion rate of
93% which was no different than a total fusion rate of 96% in the Acutrak 2
headless compression screw group (Chi- square = 0.7, p = 0.4).
Conclusions:
Arthrodesis in the small joints of the hand can be achieved with
either the Acutrak 2 headless compression screw or Kirschners wires. A shorter
time to fusion using the Acutrak 2 headless compression screw as compared to
Kirschner wires should be considered when choosing between the two methods.
No conflicts of interest reported
88.