Rothwell A G, O'Neill L, Cragg K
Department of Orthopaedic Surgery and Musculoskeletal Medicine, Christchurch School of Medicine, New Zealand.
J Hand Surg Am. 1996 Sep;21(5):771-7. doi: 10.1016/S0363-5023(96)80190-0.
A simplified technique of the Sauvé-Kapandji (SK) procedure for disorders of the distal radioulnar joint (DRUJ) is described. The DRUJ is transfixed by a screw but is not formally exposed and fused, the periosteum of the distal ulna is not excised, and the pronator quadratus is not advanced into the pseudarthrosis. Stability of the ulna shaft is obtained by suturing the sheath of the extensor carpi ulnaris (ECU) and periosteum as a single layer firmly over the ulnar stump and pseudarthrosis. The operating time averages 20 minutes. Review of 28 wrists demonstrated relief of pain in 27; 80 degrees or greater of pronation and supination in 19 and 20, respectively; fusion of the DRUJ in 18; and ulnar carpal shift in 3. The main complications were related to screw placement and length and prominence of the ECU tendon. The simplified SK procedure reliably relieves pain and restores movement at the DRUJ.
本文描述了一种简化的Sauvé-Kapandji（SK）手术技术，用于治疗桡尺远侧关节（DRUJ）疾病。通过螺钉固定DRUJ，但不进行正式的暴露和融合，不切除尺骨远端的骨膜，也不将旋前方肌推进到假关节处。通过将尺侧腕伸肌（ECU）腱鞘和骨膜作为单层牢固地缝合在尺骨残端和假关节上方，获得尺骨干的稳定性。手术时间平均为20分钟。对28例腕关节的回顾显示，27例疼痛缓解；19例旋前和20例旋后分别达到80度或更大；18例DRUJ融合；3例出现尺骨向腕侧移位。主要并发症与螺钉置入、ECU肌腱的长度和突出有关。简化的SK手术能可靠地缓解疼痛并恢复DRUJ的活动。
