Department of Orthopaedic Surgery, Shakaihoken Kobe Central Hospital, 2-1-1 Soyama-cho, Kita-ku, Kobe, 651-1145, Japan.
Mod Rheumatol. 2011 Feb;21(1):37-42. doi: 10.1007/s10165-010-0346-y. Epub 2010 Aug 25.
The Sauvé-Kapandji (S-K) procedure is a common treatment for rheumatoid wrists, but in some cases severe bone destruction makes this operative modality difficult to perform, while also resulting in a poor outcome. A modified S-K procedure for these wrists has been reported, but the clinical outcomes of the modified procedure are unclear. This study evaluated 24 wrists in 20 patients who underwent the modified S-K procedure. The mean follow-up period was 34.5 months. The clinical assessments were range of motion, carpal bone translation and bony shelf size. The range of motion and carpal bone translation were similar to those produced by the S-K procedure. In regard to bony shelf size, wrists with an excessively large bony shelf tended to have a progression of carpal bone translation toward the palmar direction due to the residual malposition of the ECU tendon. The modified S-K procedure appears to be a safe and effective surgical alternative for the treatment of severely destroyed rheumatoid wrists. Although the modified procedure allows for the adjustment of the bony shelf size, it should not be used with wrists that have an excessively large bony shelf.
Sauvé-Kapandji（S-K）手术是治疗类风湿性手腕的常用方法，但在某些情况下，严重的骨质破坏使得这种手术方式难以实施，同时也导致预后不佳。已经报道了一种改良的 S-K 手术方法用于治疗这些手腕，但该改良手术方法的临床效果尚不清楚。本研究评估了 20 例 24 个手腕接受改良 S-K 手术的患者。平均随访时间为 34.5 个月。临床评估包括关节活动度、腕骨平移和骨架大小。关节活动度和腕骨平移与 S-K 手术相似。就骨架大小而言，由于 ECU 肌腱残留的错位，骨架过大的手腕往往会出现腕骨向掌侧平移的进展。改良的 S-K 手术似乎是治疗严重破坏的类风湿性手腕的一种安全有效的手术选择。虽然改良的手术可以调整骨架的大小，但不应该用于骨架过大的手腕。
