Degreef Ilse, De Smet Luc
The University Hospital Pellenberg (K.U.L.), Lubbeek, Belgium.
Acta Orthop Belg. 2013 Apr;79(2):141-5.
Failure of the distal radioulnar joint leads to significant dysfunction of the upper limb. Numerous surgical procedures have been suggested to address this problem. In degenerative arthritis, joint instability and ulnar stump dislocation after salvage procedures such as Darrach distal resection or Sauvé-Kapandji distal fusion, an ideal solution may not be available. The ultimate option to restore distal ulna stability in these cases is to fuse the ulna and radius. Obviously, the morbidity of one bone forearm with complete loss of pronation - supination is very high and such a decision is never taken lightly. We present a challenging case series of gross radioulnar arthritis and instability with an acceptable medium-term outcome after semiconstrained Scheker arthroplasty of the distal radioulnar joint. We conclude that in selected cases with unsolvable distal radio-ulnar instability and loss of the DRUJ joint, the Scheker arthroplasty may offer a valuable solution.
桡尺远侧关节功能障碍会导致上肢严重功能障碍。针对这一问题，人们提出了多种外科手术方法。在退行性关节炎中，采用诸如Darrach远端切除术或Sauvé-Kapandji远端融合术等挽救性手术后出现关节不稳定和尺骨残端脱位时，可能没有理想的解决方案。在这些病例中，恢复尺骨远端稳定性的最终选择是将尺骨和桡骨融合。显然，单骨前臂完全丧失旋前 - 旋后功能的发病率非常高，因此做出这样的决定绝不能掉以轻心。我们展示了一组具有挑战性的严重桡尺关节炎和不稳定病例，在进行桡尺远侧关节半限制Scheker关节置换术后获得了可接受的中期结果。我们得出结论，在某些桡尺远侧关节不稳定且无法解决以及DRUJ关节丧失功能的病例中，Scheker关节置换术可能是一种有价值的解决方案。
