McMurtry R Y, Paley D, Marks P, Axelrod T
Sunnybrook Medical Centre, University of Toronto, Canada.
J Hand Surg Am. 1990 Mar;15(2):224-31. doi: 10.1016/0363-5023(90)90099-d.
Clinical and radiographic assessment of the results of 40 Swanson silicone ulnar head prosthesis implants in three different patient groups is presented. Twenty-eight were done for treatment of rheumatoid arthritis, eight for ulnoradial impingement after the Darrach procedure, and four for ulnocarpal impingement resulting from malunited Colles' fractures. Patients were reviewed 12 to 48 months after operation (mean, 29 months). Seventy-eight percent of patients reported relief of pain and improved function. Radiologic examination showed that all patients exhibited resorption of the distal ulna (mean 4.4 mm) and that resorption was worst in the group with rheumatoid arthritis. Bone resorption about the implant predisposed the cap to both side-to-side tilt and pistoning of the prosthesis on supination and pronation. There was a 10% revision rate because of silicone synovitis. Although clinical results remain satisfactory for patients with rheumatoid arthritis and ulnocarpal impingement, the radiologic results suggest that Swanson ulnar head replacement should be restricted to elderly patients with rheumatoid arthritis.
本文介绍了对三个不同患者组中40例植入Swanson硅胶尺骨头假体的结果进行的临床和影像学评估。其中28例用于治疗类风湿性关节炎，8例用于Darrach手术后的尺桡撞击，4例用于Colles骨折畸形愈合导致的尺腕撞击。术后12至48个月（平均29个月）对患者进行了复查。78%的患者报告疼痛减轻且功能改善。放射学检查显示，所有患者均出现尺骨远端吸收（平均4.4毫米），且在类风湿性关节炎组中吸收最为严重。植入物周围的骨吸收使假体帽在旋前和旋后时容易出现左右倾斜和活塞样运动。因硅胶滑膜炎导致的翻修率为10%。尽管类风湿性关节炎和尺腕撞击患者的临床结果仍然令人满意，但放射学结果表明，Swanson尺骨头置换应仅限于老年类风湿性关节炎患者。
