Department of Orthopaedic Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
Department of Orthopaedic Surgery, Kanazawa University Hospital, Kanazawa, Japan.
J Hand Surg Asian Pac Vol. 2022 Jun;27(3):541-547. doi: 10.1142/S2424835522500552. Epub 2022 May 27.
We have been using a simplified Sauvé-Kapandji (SK) procedure using a headless compression screw for the treatment of osteoarthritis (OA) of the distal radio-ulnar joint (DRUJ). Unlike a standard SK procedure, the simplified SK procedure does not require exposure of the DRUJ to prepare the opposing surfaces of the sigmoid fossa and the ulnar head or any procedures to stabilise the proximal stump of the ulna. The aim of this study is to report the radiological outcomes of the simplified SK procedure. We retrospectively reviewed data of all patients who underwent a simplified SK procedure for osteoarthritis of the DRUJ at our hospital between October 2008 and September 2020 with a follow-up of at least 25 weeks. Baseline demographic and clinical characteristics were investigated. We also measured radiographic parameters and performed statistical analyses to evaluate the shelf-forming region, ulnar stump and deviation of the carpal region. Our study included 10 patients with a mean follow-up of 52.3 weeks. There was no instance of complications such as nonunion of DRUJ arthrodesis, callus formation at ulnar pseudoarthrosis and painful instability at the proximal stump of the ulna. According to the Wilcoxon signed rank test, no radiographic parameters significantly changed during the follow-up period. There was a significant negative correlation between radioulnar width and the variation of ulnar translation index. All radiographic parameters were well maintained, at least during the short follow-up period. There was no instance of nonunion of DRUJ arthrodesis. The simplified SK with simple headless compression screw insertion may be a reliable method for treating OA of the DRUJ. Level IV (Therapeutic).
我们一直在使用一种简化的 Sauvé-Kapandji(SK)手术,采用无头加压螺钉治疗桡尺远侧关节(DRUJ)骨关节炎(OA)。与标准 SK 手术不同,简化 SK 手术不需要暴露 DRUJ 来准备乙状切迹和尺骨头的对合面,也不需要进行任何稳定尺骨近段残端的手术。本研究旨在报告简化 SK 手术的放射学结果。
我们回顾性分析了 2008 年 10 月至 2020 年 9 月期间在我院接受简化 SK 手术治疗 DRUJ OA 的所有患者的资料,随访时间至少 25 周。我们研究了基线人口统计学和临床特征。我们还测量了影像学参数,并进行了统计分析,以评估架形成区、尺骨残端和腕骨区偏斜。
我们的研究纳入了 10 例患者,平均随访 52.3 周。没有出现 DRUJ 融合不愈合、尺骨假关节处骨痂形成和尺骨近段残端疼痛不稳定等并发症。根据 Wilcoxon 符号秩检验,在随访期间没有影像学参数有显著变化。桡尺宽度与尺骨平移指数变化之间存在显著负相关。
所有影像学参数在随访期间至少得到了良好的维持。没有出现 DRUJ 融合不愈合的情况。简单的无头加压螺钉插入的简化 SK 可能是治疗 DRUJ OA 的可靠方法。
IV 级(治疗)。