De Witte Pieter Bas, Wijffels Mathieu, Jupiter Jesse B, Ring David
Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston 02114, USA.
Acta Orthop Belg. 2009 Jun;75(3):316-22.
Over a 6-year-period, 15 women and 11 men with a mean age of 53 years (range, 24 to 80 years) had resection of the distal part of the ulna (Darrach's procedure) to address stiffness, instability, non-union, or substantial radioulnar length discrepancy after trauma. At an average follow-up of 21 months (range, 4 to 60 months), the improvement in total arc of forearm rotation averaged 87 degrees (range, 0 degrees to 160 degrees), from an average of 49 degrees to an average of 136 degrees (p < 0.001). The proportion of patients with occasional or continuous pain after the Darrach procedure (7 after vs. 16 prior ; p = 0.04) was significantly reduced. Only two patients had reoperation related to the residual ulna. In this study, the Darrach procedure improved forearm rotation and pain in patients with posttraumatic stiffness, instability, nonunion, or substantial radioulnar length discrepancy with a low complication and re-operation rate.
在6年期间，15名女性和11名男性（平均年龄53岁，范围24至80岁）接受了尺骨远端切除术（Darrach手术），以解决创伤后出现的僵硬、不稳定、不愈合或明显的尺桡骨长度差异问题。平均随访21个月（范围4至60个月），前臂旋转总弧度的改善平均为87度（范围0度至160度），从平均49度提高到平均136度（p < 0.001）。Darrach手术后偶尔或持续疼痛的患者比例（术后7例 vs. 术前16例；p = 0.04）显著降低。只有两名患者因残留尺骨问题接受了再次手术。在本研究中，Darrach手术改善了创伤后僵硬、不稳定、不愈合或明显尺桡骨长度差异患者的前臂旋转和疼痛情况，且并发症和再次手术率较低。
