Daecke W, Martini A K, Streich N A
Sektion für Hand- und Mikrochirurgie, Stiftung Orthopädische Universitätsklinik Heidelberg, Germany.
Handchir Mikrochir Plast Chir. 2003 May;35(3):164-9. doi: 10.1055/s-2003-41976.
We present the preliminary results of a retrospective study on 56 patients who underwent the Kapandji-Sauvé procedure for chronic disorders of the distal radioulnar joint (DRUJ). Outcome was assessed with special regard to the long-term results. The average follow-up was 5.9 years (1 to 12 years). 15 of the 56 operations were performed before 1996. Most procedures were performed because of secondary arthrosis or chronic dislocation of the DRUJ after distal radius fracture. Patients were assessed for pain, range of motion of wrist and forearm and radiological features. The DASH score and Mayo wrist score were used. Pain was improved in 94 % of the patients, but only 53 % were free of symptoms during heavy manual labour concerning the operated site. In four cases symptoms of ulnar impingement were found. Improvement in range of motion of wrist and forearm was significant. The post-operative DASH score was 22.6 +/- 20.0 and the Mayo wrist score was 79.5 +/- 14.6. One non-union of the DRUJ with consecutive fracture of the fixation screw and an algodystrophy in another case were found as postoperative complications. The only long-term complication consisted of a beginning humeroradial arthrosis ten years after the operation. The results demonstrate high patient satisfaction and reliable improvement in range of motion. Our results confirm the Kapandji-Sauvé procedure to be a reliable salvage procedure for arthrosis or chronic dislocation of the DRUJ even after long-term follow up.
我们展示了一项针对56例因桡尺远侧关节(DRUJ)慢性疾病接受卡潘迪-索韦手术患者的回顾性研究的初步结果。特别关注长期结果对疗效进行了评估。平均随访时间为5.9年(1至12年)。56例手术中有15例在1996年之前进行。大多数手术是由于桡骨远端骨折后DRUJ继发关节病或慢性脱位。对患者的疼痛、腕关节和前臂活动范围以及放射学特征进行了评估。使用了DASH评分和梅奥腕关节评分。94%的患者疼痛得到改善,但只有53%的患者在涉及手术部位的繁重体力劳动期间无症状。在4例中发现了尺骨撞击症状。腕关节和前臂活动范围有显著改善。术后DASH评分为22.6±20.0,梅奥腕关节评分为79.5±14.6。发现1例DRUJ不愈合伴固定螺钉连续骨折,另1例出现营养障碍,均为术后并发症。唯一的长期并发症是术后10年出现肱桡关节病初期。结果显示患者满意度高,活动范围有可靠改善。我们的结果证实,即使经过长期随访,卡潘迪-索韦手术仍是治疗DRUJ关节病或慢性脱位的可靠挽救手术。