Fernandez Diego L, Joneschild Elizabeth S, Abella Diego M
Department of Orthopaedic Surgery, Lindenhof Hospital, Bern, Switzerland.
Clin Orthop Relat Res. 2006 Apr;445:100-7. doi: 10.1097/01.blo.0000205901.13609.70.
Radioulnar convergence is a painful complication after a Sauvé-Kapandji procedure, with a reported incidence of 13% to 39%. We evaluated 10 patients with painful radioulnar convergence treated with a spherical ulnar head prosthesis proximal to the radioulnar fusion mass. At a mean follow-up of 2.6 years, patients were evaluated clinically and radiographically to determine whether an ulnar head replacement could restore forearm stability, prevent radioulnar convergence, and reduce pain. Postoperatively, no patient had subjective complaints of radioulnar convergence or clinical signs of distal ulnar instability. Pain had improved in all patients. Grip strength, expressed as a percentage of the uninjured hand, improved on average from 27% to 55%. Range of motion improved in seven patients, worsened in two and remained the same in one. Nine of 10 patients returned to their previous occupation with an average working capacity of 76%. The prosthesis was stable radiographically in all patients. Complications included two fractures of the radioulnar fusion mass and the development of painful periprosthetic calcifications in one patient. Placement of a spherical ulnar head prosthesis after a Sauvé-Kapandji procedure provides adequate early results for patients with painful radioulnar convergence.
Therapeutic study, level IV (case series).
桡尺骨融合是Sauvé-Kapandji手术后一种疼痛性并发症，报道的发生率为13%至39%。我们评估了10例因桡尺骨融合疼痛而接受在桡尺骨融合块近端植入球形尺骨头假体治疗的患者。平均随访2.6年时，对患者进行临床和影像学评估，以确定尺骨头置换能否恢复前臂稳定性、预防桡尺骨融合并减轻疼痛。术后，没有患者有桡尺骨融合的主观主诉或尺骨远端不稳定的临床体征。所有患者的疼痛均有改善。握力以健侧手的百分比表示，平均从27%提高到55%。7例患者的活动范围改善，2例恶化，1例保持不变。10例患者中有9例恢复了先前的工作，平均工作能力为76%。所有患者的假体在影像学上均稳定。并发症包括2例桡尺骨融合块骨折和1例患者出现假体周围疼痛性钙化。Sauvé-Kapandji手术后植入球形尺骨头假体为桡尺骨融合疼痛患者提供了良好的早期效果。
治疗性研究，IV级（病例系列）。
