Alnot J Y, Leroux D
Ann Chir Main. 1985;4(4):294-305. doi: 10.1016/s0753-9053(85)80049-1.
The authors studied a series of 25 rheumatoid wrists, stages II and III according to Steinbrocker or Larsen, treated between 1981 and 1983 by realignment-stabilization synovectomy. The mean follow-up period was 2 1/2 years. The different steps of the operation--articular and tenosynovectomy, tendon transfers associated with dorsal ligamentoplasty--have an additive effect in achieving relief of pain, with preservation of the pre-existing mobility and long-term stability in both the frontal and sagittal planes. In other studies, resection of the ulnar head results in a 40 p. cent increment in instability with notably aggravation of ulnar sliding. Preservation of the distal radioulnar articulation according to Sauve-Kapandji's operation constitutes a new approach to rheumatoid arthritis and, in our opinion, appears to be simple and is very efficient in stabilizing the wrist immediately, thus allowing early rehabilitation of these patients. Long-term stability is affirmed by clinical and roentgenologic follow-up.
作者研究了1981年至1983年间根据斯坦布罗克或拉森分期处于II期和III期的25例类风湿性腕关节，采用复位稳定滑膜切除术进行治疗。平均随访期为2年半。手术的不同步骤——关节和腱鞘切除术、与背侧韧带成形术相关的肌腱转移——在缓解疼痛方面具有累加效应，同时保留了术前的活动度以及额状面和矢状面的长期稳定性。在其他研究中，切除尺骨头会导致不稳定性增加40%，尺骨滑动明显加重。根据索韦-卡潘迪手术保留桡尺远侧关节是类风湿性关节炎的一种新方法，在我们看来，它似乎简单易行，能立即有效地稳定腕关节，从而使这些患者能够早期康复。临床和放射学随访证实了长期稳定性。
