Kawabata Akira, Egi Takeshi, Tsuboi Hideki, Takeuchi Eiji, Fujita Satoru, Masada Kazuhiro, Shi Kenrin
Department of Orthopaedic Surgery, Higashi-Sumiyoshi Morimoto Hospital , Higashi sumiyoshi-ku, Osaka , Japan.
Mod Rheumatol. 2014 May;24(3):426-9. doi: 10.3109/14397595.2013.843742. Epub 2013 Nov 4.
We performed a modified Sauvé-Kapandji procedure for treating disorders of distal radioulnar joint in patients with rheumatoid arthritis (RA). This procedure involves resecting the distal part of the ulna, rotating the resected portion by 90° and fixating it with the distal part of the radius for shelf plasty. The purpose of this study was to examine the clinical and radiographic outcomes of this procedure with more than 5 years' follow-up.
We studied 32 wrists of 27 RA patients with the mean follow-up of 93.1 months after operation. Pain, grip strength and range of motion of the wrist were examined clinically, while two indices for evaluation of ulnar and palmar translation of the carpus, carpal translation index and palmar carpal subluxation ratio were calculated on radiographs.
The wrist pain reduced in all cases. Range of motion increased significantly regarding pronation and supination but decreased significantly regarding flexion. Change in grip power was not significant. No significant differences were recognized between radiographic indices, suggesting carpal alignment was maintained well throughout the follow-up period.
We think this procedure could be applied for distal radioulnar joint disorders in RA patients with promising clinical as well as radiographic outcomes over a long period.
我们采用改良的Sauvé-Kapandji手术治疗类风湿关节炎（RA）患者的桡尺远侧关节紊乱。该手术包括切除尺骨远端，将切除部分旋转90°，并用桡骨远端固定以进行骨嵴成形术。本研究的目的是对该手术进行超过5年的随访，以检查其临床和影像学结果。
我们研究了27例RA患者的32个腕关节，术后平均随访93.1个月。临床检查手腕的疼痛、握力和活动范围，同时在X线片上计算两个评估腕骨尺侧和掌侧移位的指标，即腕骨移位指数和掌侧腕骨半脱位率。
所有病例手腕疼痛均减轻。旋前和旋后的活动范围显著增加，但屈曲的活动范围显著减小。握力变化不显著。影像学指标之间无显著差异，表明在整个随访期间腕骨对线保持良好。
我们认为该手术可应用于RA患者的桡尺远侧关节紊乱，长期来看具有良好的临床和影像学结果。
