Gadzaly D
Handchir Mikrochir Plast Chir. 1985 Jul;17(4):203-10.
Defects in the wrist and carpal bones, caused by trauma or disease, can be treated by denervation, resection-arthroplasty, arthrodesis or prosthetic replacement. In the last few years the use of the alloplasty has developed slowly in the German speaking countries. As in the American Field Clinic, surgeons should evaluate all their cases by the same criteria. Wrist: 109 prostheses were implanted by six surgeons, 51 Meuli-prostheses, one Gschwend-design and 57 Swanson-spacers. The spacer seems to be simpler and less complicated. Such complications were encountered in 40% of the prostheses, but in only one with the spacer. The scaphoid replacement, of which 227 cases are described by ten surgeons, is the most widely used in our countries. The main risk is subluxation, caused by technical errors or use of an incorrect size of spacer. The complication rate varies from seven to fourty percent. The lunate replacement--140 cases by twelve surgeons--is less common, probably because of initial failures. Correct implantation and size of the spacer are necessary for good results. Complication rate varies from 6.4 to 55 percent. A high percentage of failures is attributable to lack of operative experience. Koob is the only one who has experience with his own design "Essen". A long-term follow-up of sixteen cases shows failures in two cases, but an increase of arthrosis.
由创伤或疾病引起的腕部和腕骨缺陷，可通过去神经支配、切除关节成形术、关节融合术或假体置换进行治疗。在过去几年中，同种异体成形术在德语国家的应用发展缓慢。与美国野战诊所一样，外科医生应以相同标准评估所有病例。腕部：六位外科医生植入了109个假体，其中51个Meuli假体、1个Gschwend设计的假体和57个Swanson间隔物。间隔物似乎更简单、并发症更少。40%的假体出现了此类并发症，但使用间隔物的仅出现了一例。舟状骨置换术是我国应用最广泛的，十位外科医生描述了227例该手术。主要风险是半脱位，由技术失误或使用尺寸不当的间隔物引起。并发症发生率在7%至40%之间。月骨置换术——十二位外科医生进行了140例——不太常见，可能是因为初期出现了失败案例。正确植入间隔物并选择合适尺寸对取得良好效果很有必要。并发症发生率在6.4%至55%之间。高比例的失败归因于缺乏手术经验。库布是唯一对自己设计的“埃森”假体有经验的人。对16例患者的长期随访显示，有2例失败，但关节病有所增加。
