Virginia Commonwealth University Health System, Richmond, USA.
Wright State University, Dayton, OH, USA.
Hand (N Y). 2024 Jan;19(1):68-73. doi: 10.1177/15589447221107697. Epub 2022 Jul 9.
To review the available literature on Darrach and Sauvé-Kapandji (SK) procedures and perform a systematic review to identify differences in clinical outcomes. We hypothesized that SK would have a higher complication rate without significant clinical benefit.
A literature search was conducted using PubMed, EMBASE, Cochrane Library, and SCOPUS (from inception to January 2020) to identify studies evaluating outcomes of Darrach and SK procedures. Primary outcome measures included the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, range of motion, grip strength, complications, and overall satisfaction.
A total of 103 articles were identified and screened, and of these, 44 full-text articles were used for data extraction and qualitative analysis. Outcomes were similar for QuickDASH scores, grip strength, and range of motion, as was overall satisfaction. Specifically, satisfaction rates for stabilized SK and Darrach procedures in patients without rheumatoid arthritis were comparable at 70.2% and 72.6%, respectively. Average QuickDASH scores were similar (21 for Darrach and 29 for SK). Mechanical symptoms due to stump instability occur with either procedure but were higher with the Darrach procedure (12.5% compared with 6.8%). The SK had more surgery-related complications such as nonunions (2.3%), symptomatic hardware, and reoperations (6.8% compared with 3.2%).
Both Darrach and SK procedures provide comparable satisfaction rates regardless of the underlying pathology. Improvement in range of motion, strength, and overall function is similar for both procedures; however, the reoperation rate is higher with SK.
回顾有关 Darrach 和 Sauvé-Kapandji（SK）手术的现有文献，并进行系统评价以确定临床结果的差异。我们假设 SK 的并发症发生率更高，但没有明显的临床获益。
使用 PubMed、EMBASE、Cochrane 图书馆和 SCOPUS（从开始到 2020 年 1 月）进行文献检索，以确定评估 Darrach 和 SK 手术结果的研究。主要结果测量包括快速上肢、肩部和手部残疾问卷（QuickDASH）评分、活动范围、握力、并发症和总体满意度。
共确定了 103 篇文章进行筛选，其中 44 篇全文文章用于数据提取和定性分析。QuickDASH 评分、握力和活动范围以及总体满意度结果相似。具体而言，在没有类风湿关节炎的患者中，稳定型 SK 和 Darrach 手术的满意度分别为 70.2%和 72.6%，相似。平均 QuickDASH 评分也相似（Darrach 为 21，SK 为 29）。残端不稳定引起的机械症状在两种手术中均可发生，但在 Darrach 手术中更为常见（12.5%比 6.8%）。SK 手术相关并发症更多，如不愈合（2.3%）、有症状的内固定和再次手术（6.8%比 3.2%）。
无论潜在病理如何，Darrach 和 SK 手术都能提供相似的满意度。两种手术在改善活动范围、力量和整体功能方面相似；然而，SK 的再次手术率更高。
