Kunze M-D, Neubrech F, Sauerbier M
Abteilung für Plastische, Hand- und Rekonstruktive Chirurgie, BG-Unfallklinik Frankfurt am Main gGmbH, Akademisches Lehrkrankenhaus der Goethe-Universität Frankfurt am Main, Friedberger Landstraße 430, 60389, Frankfurt am Main, Deutschland.
Orthopade. 2018 Aug;47(8):677-683. doi: 10.1007/s00132-018-3583-y.
A stable distal radioulnar joint (DRUJ) is mandatory for the rotation and load transmission in the forearm and wrist. Salvage procedures such as the Darrach operation, Bowers arthroplasty, and the Kapandji-Sauvé procedure include the potential risk of dynamic radioulnar instability and impingement, despite stabilizing techniques addressing the soft tissues.
In an attempt to stabilize the distal forearm mechanically following ulnar head resection, various endoprostheses have been developed to replace the ulnar head. These prostheses can be used for secondary treatment of persistent complaints and unsatisfactory results after ulnar head resection, but also in the primary treatment of osteoarthritis of the DRUJ. Based on promising results concerning improvement in pain, range of motion, and grip strength, with proper indications ulnar head prostheses should be considered as a valuable treatment option for osteoarthritis of the DRUJ.
稳定的下尺桡关节(DRUJ)对于前臂和腕部的旋转及负荷传递至关重要。诸如Darrach手术、Bowers关节成形术和Kapandji-Sauvé手术等挽救性手术,尽管采用了针对软组织的稳定技术,但仍存在动态下尺桡关节不稳定和撞击的潜在风险。
为了在尺骨头切除术后机械性地稳定前臂远端,人们开发了各种假体来替代尺骨头。这些假体可用于尺骨头切除术后持续性症状和不满意结果的二次治疗,也可用于DRUJ骨关节炎的初次治疗。基于在疼痛改善、活动范围和握力方面的 promising results,在有适当指征的情况下,尺骨头假体应被视为DRUJ骨关节炎的一种有价值的治疗选择。