Ross Mark, Thomas James, Couzens Gregory, Coleman Stephen
Hand and Upper Limb Unit, Department of Orthopaedic Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Tech Hand Up Extrem Surg. 2007 Mar;11(1):87-92. doi: 10.1097/bth.0b013e318033b537.
The Sauvé-Kapandji procedure has been commonly performed in the setting of posttraumatic osteoarthritis of the distal radioulnar joint. A recognized complication is instability of the proximal ulnar stump, which may occur in up to 33% of cases. Salvage of the failed Sauvé-Kapandji procedure in this setting is difficult and can sometimes involve sacrifice of forearm rotation. We report the results of 3 cases of a new salvage procedure in this setting. The radioulnar pseudarthrosis was taken down; ulnar continuity was restored with an intercalary graft; and forearm rotation was restored with matched hemiresection and interposition arthroplasty at the site of previous radioulnar fusion. Postoperatively, all patients achieved good forearm rotation (mean supination, 60 degrees; mean pronation, 65 degrees), had no symptoms of instability, and were satisfied with the results of the procedure. Disabilities of the Arm, Shoulder and Hand scores improved from preoperative mean of 55 to postoperative mean of 18.
Sauvé-Kapandji手术常用于桡尺远侧关节创伤后骨关节炎的治疗。一种公认的并发症是尺骨近端残端不稳定，发生率可达33%。在这种情况下挽救失败的Sauvé-Kapandji手术很困难，有时可能需要牺牲前臂旋转功能。我们报告了3例在此情况下采用新的挽救手术的结果。切除桡尺假关节；用嵌插植骨恢复尺骨连续性；在前次桡尺融合部位进行匹配的半切除和间置关节成形术以恢复前臂旋转功能。术后，所有患者前臂旋转功能良好（平均旋前60度；平均旋后65度），无不稳定症状，对手术结果满意。上肢、肩部和手部功能障碍评分从术前平均55分改善至术后平均18分。
