Mayo Clinic, Rochester, MN, USA.
SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
Hand (N Y). 2022 Sep;17(5):963-968. doi: 10.1177/1558944720966725. Epub 2020 Nov 22.
Dysfunction of the distal radioulnar joint (DRUJ) can be significantly debilitating. The Sauve-Kapandji (S-K) procedure can be indicated to address multiple etiologies of DRUJ dysfunction. The purpose of this study was to review our institution's results performing the S-K procedure for DRUJ dysfunction in terms of clinical and radiographic outcomes, as well as complications and reoperations.
A retrospective review of S-K procedures performed at 2 institutions between 1998 and 2017 with a minimum of 1-year follow-up was performed. Preoperative and postoperative visual analog scale (VAS) pain, grip strength, and wrist range of motion were reviewed. Radiographs were reviewed for DRUJ healing, carpal translation, and radiocarpal degenerative changes.
The cohort included 35 patients. The mean age was 51 years. The mean follow-up was 49.5 months. The postoperative range of motion was unchanged in regard to pronation, supination, and wrist extension. There was a decrease in wrist flexion from 43 degrees to 34 degrees. Successful union was noted in 100% of the wrists. There was 1 case (2.8%) of progressive ulnar translation and 4 major complications (11.3%).
The S-K procedure has several theoretical benefits compared to other procedures for DRUJ dysfunction with results of this study demonstrating excellent pain relief, improved postoperative grip strength, retained wrist pronation, supination, and extension, high rate of successful arthrodesis and low rate of major complications.
Level IV.
桡尺远侧关节(DRUJ)功能障碍可能会严重影响患者的活动能力。Sauve-Kapandji(S-K)手术可用于治疗多种DRUJ 功能障碍的病因。本研究旨在回顾本机构采用 S-K 手术治疗 DRUJ 功能障碍的临床和影像学结果、并发症和再次手术情况。
对 1998 年至 2017 年在 2 家机构行 S-K 手术的患者进行回顾性研究,所有患者均获得至少 1 年的随访。评估术前和术后视觉模拟量表(VAS)疼痛评分、握力和腕关节活动度。评估 X 线片上 DRUJ 愈合、腕骨间位移和桡腕关节退行性改变情况。
本研究共纳入 35 例患者,平均年龄为 51 岁,平均随访时间为 49.5 个月。术后旋前、旋后和腕关节伸展活动度无明显变化,腕关节屈曲度由 43°减少至 34°。所有患者均获得骨性融合,1 例(2.8%)出现尺侧渐进性移位,4 例(11.3%)出现严重并发症。
与其他治疗 DRUJ 功能障碍的手术相比,S-K 手术具有诸多理论优势,本研究结果表明该手术可有效缓解疼痛,改善术后握力,保留腕关节旋前、旋后和伸展功能,融合成功率高,严重并发症发生率低。
IV 级。