Fuller Zachary, Gupta Arjun, Herzog Isabel, Weisberger Joseph, Ahmed Irfan H, Vosbikian Michael M, Ignatiuk Ashley
Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
Department of Surgery, Division of Plastic and Reconstructive Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
J Hand Microsurg. 2025 Apr 28;17(4):100275. doi: 10.1016/j.jham.2025.100275. eCollection 2025 Jul.
Semi-constrained total distal radioulnar joint (DRUJ) arthroplasty with Aptis-Scheker implant has demonstrated excellent results in patients with end-stage rheumatoid arthritis (RA) of the wrist. However, clinical success of the Scheker implant in restoring range of motion may be limited in patients with concomitant degenerative disease at the proximal radioulnar joint and radiocapitellar joint, which work in tandem with the DRUJ to allow pronosupination of the forearm. Among treatment options for elbow arthritis, standalone radial head arthroplasty remains poorly studied in the context of RA, despite being used widely in trauma patients. Here, we illustrate the surgical technique for combined total DRUJ arthroplasty with a Scheker implant and radial head arthroplasty to treat long-standing, refractory RA, at the wrist and elbow joints, with excellent results at 1-year follow-up.
采用Aptis-Scheker植入物的半限制性全远端尺桡关节（DRUJ）置换术在腕关节终末期类风湿关节炎（RA）患者中已显示出优异的效果。然而，对于同时存在近端尺桡关节和桡骨头关节退行性疾病的患者，Scheker植入物在恢复活动范围方面的临床成功率可能会受到限制，近端尺桡关节和桡骨头关节与DRUJ协同作用，使前臂能够进行旋前和旋后动作。在肘关节关节炎的治疗选择中，尽管桡骨头置换术在创伤患者中广泛应用，但在RA背景下对其单独研究较少。在此，我们阐述了联合使用Scheker植入物进行全DRUJ置换术和桡骨头置换术治疗腕关节和肘关节长期难治性RA的手术技术，1年随访结果良好。
