Kato Tomoyuki, Suzuki Taku, Kameyama Makoto, Okazaki Masato, Morisawa Yasushi, Nishiwaki Masao, Nakamura Toshiyasu, Sato Kazuki, Iwamoto Takuji
Department of Orthopaedic Surgery, Ogikubo Hospital, Suginami-ku, Tokyo, Japan.
Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
J Wrist Surg. 2021 Jun;10(3):190-195. doi: 10.1055/s-0040-1721452. Epub 2020 Dec 26.
Previous study demonstrated that distal radioulnar joint (DRUJ) plays a biomechanical role in extension and flexion of the wrist and suggested that fixation of the DRUJ could lead to loss of motion of the wrist. Little is known about the pre- and postoperative range of motion (ROM) after the Sauvé-Kapandji (S-K) and Darrach procedures without tendon rupture. To understand the accurate ROM of the wrist after the S-K and Darrach procedures, enrollment of patients without subcutaneous extensor tendon rupture is needed. This study aimed to investigate the pre- and postoperative ROM after the S-K and Darrach procedures without subcutaneous extensor tendon rupture in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). This retrospective study included 36 patients who underwent the S-K procedure and 10 patients who underwent the Darrach procedure for distal radioulnar joint disorders without extensor tendon rupture. Pre- and postoperative ROMs after the S-K and Darrach procedures were assessed 1 year after the surgery. In the S-K procedure, the mean postoperative ROM of the wrist flexion (40 degrees) was significantly lower than the mean preoperative ROM (49 degrees). In wrist extension, there were no significant differences between the mean preoperative ROM (51 degrees) and postoperative ROM (51 degrees). In the Darrach procedure, the mean postoperative ROM of the wrist flexion and extension increased compared with the mean preoperative ROM; however, there were no significant differences. In the S-K procedure, preoperative ROM of the wrist flexion decreased postoperatively. This study provides information about the accurate ROM after the S-K and Darrach procedures. This is a Level IV, therapeutic study.
先前的研究表明，桡尺远侧关节（DRUJ）在腕关节屈伸中起生物力学作用，并提示DRUJ固定可能导致腕关节活动度丧失。对于Sauvé-Kapandji（S-K）手术和Darrach手术且未发生肌腱断裂的患者，术前和术后的活动度（ROM）情况知之甚少。为了解S-K手术和Darrach手术后腕关节的准确ROM，需要纳入无皮下伸肌腱断裂的患者。 本研究旨在调查类风湿关节炎（RA）和骨关节炎（OA）患者在接受无皮下伸肌腱断裂的S-K手术和Darrach手术后的术前和术后ROM。 这项回顾性研究纳入了36例行S-K手术的患者和10例行Darrach手术治疗桡尺远侧关节疾病且未发生伸肌腱断裂的患者。在手术后1年评估S-K手术和Darrach手术后的术前和术后ROM。 在S-K手术中，术后腕关节屈曲的平均ROM（40度）显著低于术前平均ROM（49度）。在腕关节伸展方面，术前平均ROM（51度）和术后ROM（51度）之间无显著差异。在Darrach手术中，术后腕关节屈伸的平均ROM较术前平均ROM有所增加；然而，差异无统计学意义。 在S-K手术中，腕关节屈曲的术前ROM术后降低。本研究提供了S-K手术和Darrach手术后准确ROM的相关信息。 这是一项IV级治疗性研究。
