Lluch Alberto
Institut Kaplan for Surgery of the Hand and Upper Extremity, Barcelona, Spain.
J Wrist Surg. 2013 Feb;2(1):33-40. doi: 10.1055/s-0032-1333465.
Arthrodesis is the most reliable and durable surgical procedure for the treatment of a joint disorder, and its only disadvantage is the loss of motion of the fused joint. The distal radioulnar joint can be arthrodesed, while forearm pronation and supination are maintained or even improved by creating a pseudoarthrosis of the ulna just proximal to the arthrodesis. This is known as the Sauvé-Kapandji (S-K) procedure. The Sauvé-Kapandji differs from the Darrach procedure in that it preserves ulnar support of the wrist, as the distal radioulnar ligaments and ulnocarpal ligaments are maintained. Aesthetic appearance is also superior after the S-K procedure, as the normal prominence of the ulnar head, most noticeable when the forearm is in pronation, is maintained. However, the S-K is not free of possible complications, such as nonunion or delayed union of the arthrodesis, fibrous or osseous union at the pseudoarthrosis, and painful instability at the proximal ulna stump. All of these complications can be prevented if a careful surgical technique is used.
关节融合术是治疗关节疾病最可靠、最持久的外科手术，其唯一的缺点是融合关节会丧失活动度。桡尺远侧关节可以进行关节融合，同时通过在关节融合近端的尺骨处形成假关节，可维持甚至改善前臂的旋前和旋后功能。这就是所谓的Sauvé-Kapandji（S-K）手术。Sauvé-Kapandji手术与Darrach手术的不同之处在于，它保留了腕关节的尺侧支撑，因为桡尺远侧韧带和尺腕韧带得以保留。S-K手术后的美观效果也更好，因为尺骨头的正常隆起在前臂旋前时最为明显，得以保留。然而，S-K手术并非没有可能出现的并发症，如关节融合不愈合或延迟愈合、假关节处的纤维性或骨性愈合，以及尺骨近端残端的疼痛性不稳定。如果采用仔细的手术技术，所有这些并发症都是可以预防的。
