Wang Jun, Liu Gang, Huang Fuguo, Tang Shitian, Zhang Dingwei, Wang Lihui
Department of Orthopedics, Mianyang Central Hospital, Mianyang Sichuan, 621000, P.R.China.
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Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Feb 15;31(2):155-159. doi: 10.7507/1002-1892.201607041.
To evaluate the effectiveness of Sauvé-Kapandji procedure in the treatment of traumatic ulnar styloid impaction syndrome.
Between June 2010 and January 2013, 12 patients with traumatic ulnar styloid impaction syndrome were treated by Sauvé-Kapandji procedure. There were 4 men and 8 women, with an average age of 58.9 years (range, 50-69 years). The disease was caused by traffic accident in 1 case, and by falling from height in 11 cases. All patients had dislocation of the distal radioulnar joint, and 7 patients also had old fractures of the distal radius. The main clinical symptoms were pain and limited activity of the wrist joint, and the disease duration was 2-4 months (mean, 3.5 months). The visual analogue scale (VAS) was 6.2±1.4. The clinical outcomes were assessed by VAS, range of motion (ROM) of the wrist, grip strength, Evans score, and X-ray film of wrist joint during follow-up.
All patients obtained healing of incision by first intention and were followed up 37-73 months (mean, 58.4 months); no complication of infection, blood vessel injury, or nerves injury occurred. VAS was 1.2±1.0 at the final follow-up, showing significant difference when compared with preoperative one ( =9.950, =0.000). The ROM of the affected wrist joint in flexion, extension, ulnar deviation, forearm pronation and supination were improved, but the ROM of the affected side were significantly less than those of normal side ( <0.05). No significant difference was found in the grip strength and Evans score between the affected side and normal side ( =-0.885, =0.386; =-1.969, =0.062). According to Evans scores, the results were excellent in 8 cases, good in 3 cases, and fair in 1 case, with an excellent and good rate of 91.7%. Postoperative radiographs showed bony healing in all patients, with the average healing time of 3.5 months (range, 3-6 months). The instability of proximal ulna occurred in 3 cases.
Sauvé-Kapandji procedure is a reliable remedy method for traumatic ulnar styloid impaction syndrome, with favorable improvement in wrist pain and forearm rotation. However, the surgical indications for Sauvé-Kapandji procedure should be strictly controlled.
评估Sauvé-Kapandji手术治疗创伤性尺骨茎突撞击综合征的有效性。
2010年6月至2013年1月，12例创伤性尺骨茎突撞击综合征患者接受了Sauvé-Kapandji手术治疗。其中男性4例，女性8例，平均年龄58.9岁（范围50 - 69岁）。病因：交通事故致伤1例，高处坠落致伤11例。所有患者均有下尺桡关节脱位，7例患者同时合并有陈旧性桡骨远端骨折。主要临床症状为腕关节疼痛及活动受限，病程2 - 4个月（平均3.5个月）。视觉模拟评分（VAS）为6.2±1.4。随访期间通过VAS、腕关节活动度（ROM）、握力、Evans评分及腕关节X线片评估临床疗效。
所有患者切口均一期愈合，随访37 - 73个月（平均58.4个月）；未发生感染、血管损伤及神经损伤等并发症。末次随访时VAS为1.2±1.0，与术前比较差异有统计学意义（ =9.950， =0.000）。患侧腕关节的屈伸、尺偏、前臂旋前和旋后活动度均有改善，但患侧活动度明显小于健侧（ <0.05）。患侧与健侧握力及Evans评分比较差异无统计学意义（ =-0.885， =0.386； =-1.969， =0.062）。根据Evans评分，优8例，良3例，可1例，优良率为91.7%。术后X线片显示所有患者均骨性愈合，平均愈合时间3.5个月（范围3 - 6个月）。3例发生尺骨近端不稳。
Sauvé-Kapandji手术是治疗创伤性尺骨茎突撞击综合征的可靠方法，可有效改善腕关节疼痛及前臂旋转功能。但应严格掌握Sauvé-Kapandji手术的适应证。
