Hansen P, Wounlund J, Konradsen L A
Ortopaedkirurgisk afdeling O, Hillerød Sygehus.
Ugeskr Laeger. 1994 May 16;156(20):3025-7.
In a retrospective study, the effect of distal ulnar resection using the Darrach procedure was evaluated in 42 patients with post-traumatic distal radio-ulnar disability. Thirty women and 12 men, mean age 43 years were seen an average of seven years after the operation. In 57% of the cases the primary trauma was a Colles fracture. The main indication for operation was pain radiating from the distal radio-ulnar joint (83%), but seven patients were without substantial pain. 79% of the patients felt relief of pain after the operation, but 62% still suffered from occasional wrist pain. Twenty-six patients had a supination and a pronation of > or = 150 degrees postoperatively. Thirty-three patients had a dynamic handpower of > 60% of the opposite hand postoperatively. Ten patients stopped working or changed to less physically demanding jobs after the primary trauma. Three patients from this group could after the operation return to their primary physically demanding jobs. Radiographs showed no progress of radiocarpal osteoarthritis during the follow-up period. The Darrach procedure could relieve post-traumatic distal radioulnar pain conditions without adverse effect on radiocarpal function and alignment. Patients who only had mild pain symptoms preoperatively presented unsatisfactory postoperative results.
在一项回顾性研究中，对42例创伤后远侧桡尺关节功能障碍患者采用Darrach手术进行尺骨远端切除术的效果进行了评估。患者包括30名女性和12名男性，平均年龄43岁，术后平均随访7年。57%的病例原发创伤为Colles骨折。手术的主要指征是远侧桡尺关节放射痛（83%），但有7例患者无明显疼痛。79%的患者术后疼痛缓解，但62%仍偶尔有腕部疼痛。26例患者术后旋前和旋后角度≥150度。33例患者术后患侧手动态握力大于健侧的60%。10例患者在原发创伤后停止工作或更换为体力要求较低的工作。该组中有3例患者术后能够恢复到原来体力要求较高的工作。X线片显示随访期间腕关节骨关节炎无进展。Darrach手术可缓解创伤后远侧桡尺关节疼痛，且对腕关节功能和对线无不良影响。术前仅有轻度疼痛症状的患者术后效果不理想。
