Ryu J, Watson H K, Burgess R C
J Hand Surg Am. 1985 Nov;10(6 Pt 1):830-6. doi: 10.1016/s0363-5023(85)80158-1.
Rheumatoid arthritic involvement of the wrist severely limits the functional status of the upper extremity. Total wrist arthrodesis, while providing pain relief and reestablishing support, compromises the functional capacity of the hand because of lack of wrist motion. Wrist arthroplasties allow motion, but have not found wide acceptance because of instability and the recurrence of deformity. A technique for establishing an intentional fibrous nonunion between the carpus and the radius was devised 17 years ago. This fibrous hinge gives wrist stability with or without radiocarpal wrist arthrodesis while allowing painless motion at the fibrous radiocarpal hinge and at the less severely involved midcarpal joint. Twenty-three patients have been followed for more than 7 years. All patients whose wrists achieved nonunion had no pain. Twelve of the 19 wrists in which radiocarpal arthrodesis occurred had no pain, and seven had mild pain that did not limit use.
类风湿性关节炎累及腕关节会严重限制上肢的功能状态。全腕关节融合术虽然能缓解疼痛并重建支撑，但由于缺乏腕关节活动，会损害手部的功能能力。腕关节置换术能实现活动，但因不稳定和畸形复发而未被广泛接受。17年前设计了一种在腕骨和桡骨之间建立有意的纤维性骨不连的技术。这种纤维性铰链在有或没有桡腕关节融合的情况下都能提供腕关节稳定性，同时允许在纤维性桡腕铰链和受累较轻的腕中关节进行无痛活动。23例患者已随访7年以上。所有腕关节实现骨不连的患者均无疼痛。19例发生桡腕关节融合的腕关节中，12例无疼痛，7例有轻度疼痛但不影响使用。
