Fukushima Walter Yoshinori, de Moraes Vinícius Ynoe, Penteado Fernado Travaglini, Faloppa Flávio, Dos Santos João Baptista Gomes
Universidade Federal de São Paulo (UNIFESP), Department of Orthopaedics and Traumatology, SP, Brazil.
SICOT J. 2015;1:25. doi: 10.1051/sicotj/2015026. Epub 2015 Sep 22.
Proximal row carpectomy (PRC) is an option as a salvage procedure in late stage Kienböck's disease. In this study, we hypothesize that interposition of a dorsal capsular flap following PRC improves functional outcomes. No comparative study is available to assess whether interposition is effective from the functional perspective. This study aims to determine whether the addition of this procedure may improve functional outcomes at a one year assessment.
Thirty adult patients with IIIA and IIIB Lichtman stages, aged 18-54 years, were randomized into two study groups. Fourteen patients were allocated to the "no interposition group" and 16 to the "interposition" group. DASH questionnaire was used to evaluate quality of life. Cooney's system was used to assess pain, functional state, range of motion, and grip strength. Complications were also assessed. Final followup and clinical assessment occurred after 12 months.
After 12 months and no patient losses, outcomes were similar in both groups. DASH scores (41.9 (7.5) vs. 42.9 (12.8), p = 0.79)), Cooney's system (poor results, 0.6 vs. 0.14, p = 0.54), and complications were similar between groups. In conclusion, the inclusion of a dorsal capsular flap does not improve functional outcomes in PRC. Low rates of complications were found in both groups.
近端腕骨切除术（PRC）是晚期月骨无菌性坏死的一种挽救性手术选择。在本研究中，我们假设PRC术后植入背侧关节囊瓣可改善功能结局。目前尚无比较研究从功能角度评估植入是否有效。本研究旨在确定在一年的评估中增加该手术是否能改善功能结局。
30例年龄在18 - 54岁之间、Lichtman分期为IIIA和IIIB期的成年患者被随机分为两个研究组。14例患者被分配到“无植入组”，16例被分配到“植入组”。采用DASH问卷评估生活质量。使用Cooney系统评估疼痛、功能状态、活动范围和握力。同时评估并发症情况。最终随访和临床评估在12个月后进行。
12个月后且无患者失访，两组的结局相似。两组之间的DASH评分（41.9（7.5）对42.9（12.8），p = 0.79）、Cooney系统评分（较差结果，0.6对0.14，p = 0.54）以及并发症情况均相似。总之，PRC术中植入背侧关节囊瓣并不能改善功能结局。两组的并发症发生率均较低。
