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[尺桡远侧关节鲍尔斯半切除间置关节成形术后的中长期功能结果]

[Mid- to long-term functional results after Bowers' hemiresection interposition arthroplasty of the distal radio-ulnar joint].

作者信息

Spies C K, Unglaub F, Bruckner T, Müller L P, Eysel P, Seker M

机构信息

Handchirurgie, Spital Langenthal, Spital Region Oberaargau SRO AG, Langenthal, Schweiz.

Handchirurgie, Vulpius Klinik, Vulpiusstr. 29, 74906, Bad Rappenau, Deutschland.

出版信息

Orthopadie (Heidelb). 2022 Jul;51(7):556-563. doi: 10.1007/s00132-022-04237-6. Epub 2022 Mar 3.

Abstract

BACKGROUND

Bowers' hemiresection interposition arthroplasty of the distal radio-ulnar joint has been performed for decades, mainly for the treatment of osteoarthritis of the distal radio-ulnar joint. However, long-term test results are sparse.

OBJECTIVE

Evaluation of a homogeneous patient population following a mid- to long-term postoperative follow-up interval after hemiresection interposition arthroplasty.

PATIENTS AND METHODS

Twenty-five patients were evaluated 77.2 (±34.6) months after surgical therapy with regard to range of motion, grip strength and pain level. The subjective and objective scores DASH (Disabilities of Arm, Shoulder, and Hand) and MMWS (modified Mayo Wrist Score) were collected.

RESULTS

Wrist mobility is not worse than 10.4° in relation to all directions of wrist movement compared with the healthy opposite side. Coarse grip strength is reduced by an average of 5.8 kg compared with the opposite side. The pain level decreased on average from 8.2 preoperatively to 1.8 postoperatively. Postoperatively, 22 patients (88 %) had a stable distal radio-ulnar joint. At the time of follow-up DASH averaged 26.7 (±21.4) and the MMWS averaged 78 (±15.7).

DISCUSSION

Hemiresection interposition arthroplasty is a reliable and safe surgical technique with good subjective and functional outcomes in the mid- to long-term.

摘要

背景

尺桡远侧关节鲍尔斯半切除间置关节成形术已开展数十年,主要用于治疗尺桡远侧关节骨关节炎。然而,长期测试结果较少。

目的

评估半切除间置关节成形术后中长期随访的同质患者群体。

患者与方法

对25例患者在手术治疗77.2(±34.6)个月后进行评估,内容包括活动范围、握力和疼痛程度。收集主观和客观评分,即上肢、肩部和手部功能障碍评分(DASH)以及改良梅奥腕关节评分(MMWS)。

结果

与健侧相比,腕关节各方向活动度下降不超过10.4°。粗握力较对侧平均降低5.8 kg。疼痛程度平均从术前的8.2降至术后的1.8。术后,22例患者(88%)的尺桡远侧关节稳定。随访时,DASH评分为26.7(±21.4),MMWS评分为78(±15.7)。

讨论

半切除间置关节成形术是一种可靠且安全的手术技术,中长期主观和功能预后良好。

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