Hanff G, Sollerman C, Elborgh R, Pettersson H
Department of Orthopedic Surgery, Lund University Hospital, Sweden.
Scand J Rheumatol. 1990;19(4):280-4. doi: 10.3109/03009749009102534.
Synovectomy of 20 wrist joints in 15 patients with juvenile chronic arthritis (JCA) was performed and results were evaluated 3 (0.5-5) years after surgery. The surgical procedure consisted of synovectomy of the radiocarpal joint, around the ulnar head and in all intercarpal joints. Resection of the ulnar head was not performed. Results at follow-up showed that four wrist joints had been re-operated by arthrodesis because of persistent pain. In one case a spontaneous ankylosis had developed. These cases were not included in the re-examination. Of the remaining 15 cases, 12 were improved and 7 of these were totally pain-free. At follow-up, clinical examination revealed a mean improved grip strength (0.2 kp/cm2) and a mean decreased range of motion (10 degrees of flexion and extension, 16 degrees of pronation, supination unchanged). All wrist joints showed some radiographic changes preoperatively and at follow-up about half showed some further deterioration. This study indicates that the results of wrist synovectomy in patients with juvenile chronic arthritis do not differ significantly from results of wrist synovectomy in adult arthritic patients.
对15例青少年慢性关节炎（JCA）患者的20个腕关节进行了滑膜切除术，并在术后3（0.5 - 5）年评估结果。手术过程包括桡腕关节、尺骨头周围以及所有腕骨间关节的滑膜切除。未进行尺骨头切除术。随访结果显示，4个腕关节因持续疼痛而再次接受关节融合手术。有1例出现了自发融合。这些病例未纳入复查。其余15例中，12例病情改善，其中7例完全无痛。随访时，临床检查显示握力平均提高（0.2kp/cm²），活动范围平均减小（屈伸10度，旋前16度，旋后不变）。所有腕关节术前均有一些影像学改变，随访时约一半出现了进一步恶化。本研究表明，青少年慢性关节炎患者腕关节滑膜切除的结果与成年关节炎患者腕关节滑膜切除的结果无显著差异。
