Martínez Villén G, García Martínez B, Aso Vizán A
Department of orthopaedic surgery and traumatology, unit of hand surgery and microsurgery, university hospital Miguel-Servet, P° Isabel la Católica, s/n, ES-50009 Zaragoza, Spain.
Department of orthopaedic surgery and traumatology, unit of hand surgery and microsurgery, university hospital Miguel-Servet, P° Isabel la Católica, s/n, ES-50009 Zaragoza, Spain.
Chir Main. 2014 Dec;33(6):390-5. doi: 10.1016/j.main.2014.09.004. Epub 2014 Oct 22.
The purpose of this study was to report the results following implantation of a total distal radioulnar joint prosthesis in five multioperated patients with posttraumatic or Essex-Lopresti injury. The range of motion (ROM) for flexion and extension, radial deviation and ulnar deviation of the wrist, and pronation and supination of the forearm, grip strength, pain intensity through a visual analog scale (VAS), surgical complications and ability to return to work, were recorded. Subjective and objective functions were assessed using the quick DASH questionnaire and the modified Mayo wrist score, respectively. The mean postoperative follow-up was 4.3 years. Average postoperative increase in ROM was 28.8° for flexion-extension; 2.2° for radial and ulnar deviation, and 18° for pronation-supination, reaching 85.8%, 85% and 80.8% of the contralateral hand function, respectively. Grip strength increased by 6.8kg, with recovery of 78% of the strength of the unaffected hand. VAS score decreased to a mean of 6.2 postoperatively. There were complications in two cases. All five patients showed no signs of implant loosening or movement. The quick DASH score decreased from a mean of 85 preoperatively to 38.6 postoperatively. The modified Mayo wrist score increased from a mean of 24 preoperatively to 73 at final follow-up. Four patients recovered their professional and daily activities without restriction and were satisfied with the procedure; one patient with heterotopic bone formation at the distal tip of the ulnar stem did not want any further surgery and agreed to job modifications.
本研究的目的是报告5例多手术治疗的创伤后或埃塞克斯-洛普雷斯蒂损伤患者植入全远端尺桡关节假体后的结果。记录了腕关节屈伸、桡偏和尺偏以及前臂旋前和旋后的活动范围（ROM）、握力、通过视觉模拟量表（VAS）评估的疼痛强度、手术并发症以及恢复工作的能力。分别使用快速DASH问卷和改良梅奥腕关节评分评估主观和客观功能。术后平均随访4.3年。术后ROM平均增加：屈伸为28.8°；桡偏和尺偏为2.2°，旋前和旋后为18°，分别达到对侧手功能的85.8%、85%和80.8%。握力增加了6.8kg，恢复到未受影响手力量的78%。VAS评分术后降至平均6.2分。有2例出现并发症。所有5例患者均未出现植入物松动或移位迹象。快速DASH评分从术前平均85分降至术后38.6分。改良梅奥腕关节评分从术前平均24分升至最终随访时的73分。4例患者恢复了职业和日常活动且无限制，对手术满意；1例尺骨柄远端尖端出现异位骨形成的患者不想再接受任何手术，并同意调整工作。
