Ikeda Mikinori, Kawabata Akira, Suzuki Keisuke, Toyama Masahiko, Egi Takeshi
a Department of Orthopaedic Surgery , Higashisumiyoshi Morimoto Hospital , Osaka , Japan.
b Department of Orthopaedic Surgery , Yodogawa Christian Hospital , Osaka , Japan.
Mod Rheumatol. 2018 May;28(3):490-494. doi: 10.1080/14397595.2017.1366005. Epub 2017 Aug 24.
We performed the Sauvé-Kapandji procedure for treating disorders of the distal radioulnar joint (DRUJ) in patients with rheumatoid arthritis (RA) or osteoarthritis (OA). This study aimed to compare and clarify the results of the SK procedure between RA and OA patients. We report the one-year follow-up results of patients who underwent the SK procedure to correct the DRUJ disorder caused by RA or OA.
The study included 22 wrists of 19 patients with RA and 10 wrists of nine patients with OA. Pain, grip strength and range of motion of the wrist were examined clinically. For the evaluation of the stability of the carpus, ulnar stump and bone union, parameters were measured using radiographs. Shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH) was used for functional evaluation.
Wrist pain reduced in all cases, and bone union was achieved in all wrists. The QuickDASH score significantly improved in both patients with RA and OA. In patients with RA, the range of motion increased significantly with regard to supination but decreased significantly with regard to palmar flexion. Carpal alignment and ulnar stump stability were maintained well at one-year follow-up.
The Sauvé-Kapandji procedure for treating disorders of the distal radioulnar joint DRUJ showed good results clinically and radiographically, irrespective of RA or OA.
我们采用Sauvé-Kapandji手术治疗类风湿关节炎(RA)或骨关节炎(OA)患者的桡尺远侧关节(DRUJ)疾病。本研究旨在比较并阐明RA和OA患者行Sauvé-Kapandji手术(SK手术)的结果。我们报告了接受SK手术以纠正由RA或OA引起的DRUJ疾病患者的一年随访结果。
本研究纳入了19例RA患者的22个腕关节和9例OA患者的10个腕关节。临床检查了腕关节的疼痛、握力和活动范围。为评估腕骨、尺骨残端的稳定性及骨愈合情况,利用X线片测量相关参数。采用手臂、肩部和手部功能障碍简化问卷(QuickDASH)进行功能评估。
所有病例的腕关节疼痛均减轻,所有腕关节均实现了骨愈合。RA和OA患者的QuickDASH评分均显著改善。RA患者旋后活动范围显著增加,但掌屈活动范围显著减小。在一年随访时腕骨对线和尺骨残端稳定性维持良好。
无论RA或OA,采用Sauvé-Kapandji手术治疗桡尺远侧关节DRUJ疾病在临床和影像学上均显示出良好效果。