Bosco J A, Bynum D K, Bowers W H
Montefiore Medical Center, Albert Einstein College of Medicine, Department of Orthopaedic Surgery, Bronx, NY 10467.
J Arthroplasty. 1994 Feb;9(1):25-31. doi: 10.1016/0883-5403(94)90134-1.
The authors determined the outcomes of 18 consecutive Volz total wrist arthroplasties that were followed for an average of 8.6 years. Nine of these wrists were followed for 10 or more years. Fourteen wrists were replaced for rheumatoid arthritis and four for post-traumatic degenerative joint disease. Forty-nine degrees of combined flexion and extension and 25 degrees of combined ulnar and radial deviation were maintained. The balance of wrist motion was dependent upon the design and location of the metacarpal prosthesis. A 24% loss in carpal height (subsidence) occurred during the study period. Four metacarpal components were loose (22%), three of which were placed in patients with degenerative joint disease. One radial component (6%) was loose. Fifteen of 18 wrists (83%) had little or no pain. The three wrists with moderate or severe pain were in patients with degenerative joint disease. There were five (28%) complications. One revision was performed and another was recommended. Overall, the long-term outcome of total wrist arthroplasty was favorable in patients with rheumatoid arthritis.
作者对连续18例接受Volz全腕关节置换术的患者进行了随访，平均随访时间为8.6年。其中9例患者的随访时间达到或超过10年。14例患者因类风湿性关节炎接受了腕关节置换，4例因创伤后退行性关节病接受了置换。患者腕关节保持了49°的屈伸活动度以及25°的尺桡侧偏斜活动度。腕关节活动的平衡取决于掌骨假体的设计和植入位置。在研究期间，腕骨高度出现了24%的丢失（下沉）。4个掌骨部件出现松动（22%），其中3例发生在患有退行性关节病的患者中。1个桡骨部件出现松动（6%）。18例患者中有15例（83%）几乎没有疼痛或完全无痛。3例有中度或重度疼痛的患者均患有退行性关节病。共出现5例（28%）并发症。进行了1次翻修手术，另有1例建议进行翻修。总体而言，类风湿性关节炎患者接受全腕关节置换术的长期效果良好。
