Zilch H, Kauschke T
Klinik für Unfall-, Wiederherstellungs- und Handchirurgie, Harzklinik Goslar.
Unfallchirurg. 1996 Nov;99(11):841-4. doi: 10.1007/s001130050064.
The Sauvé-Kapandji procedure comprises distal radioulnar arthrodesis with screwing of the caput ulnae at the basis of the radius after the correction of the radioulnar length discrepancy. Therefore the best indications are posttraumatic changes of the distal radioulnar joint. At the same time a distal ulnar segment resection about 12 mm in length is necessary to restore forearm rotation, producing an iatrogenic pseudarthrosis. The proximal ulnar segment functionally assimilates to a rotating joint, as could be shown by X-rays. Between 1988 and 1993 this procedure was performed in 12 patients. Follow-up after an average of 38.2 months showed improvements in forearm rotation of 84% for pronation and 60% for supination. All patients had significant pain relief. Grip strength also improved, by 55%. No patient got worse postoperatively as measured by the score of Gartland and Werley. Neither non-union of the distal radioulnar joint fusion nor bony regeneration across the resected ulnar segment was seen. The good results are the consequence of adherence to a rigorous indication: no preexisting arthrosis at the radiocarpal joint.
索维-卡潘迪手术包括在纠正尺桡骨长度差异后，行尺桡远侧关节融合术，并在桡骨基部用螺钉固定尺骨头。因此，最佳适应证是尺桡远侧关节的创伤后改变。同时，为恢复前臂旋转，需要切除一段约12毫米长的尺骨远侧段，从而形成医源性假关节。X线检查显示，尺骨近侧段在功能上类似于一个旋转关节。1988年至1993年间，对12例患者实施了该手术。平均随访38.2个月后，前臂旋前旋转改善率为84%，旋后旋转改善率为60%。所有患者的疼痛均显著缓解。握力也提高了55%。根据加特兰和韦利评分标准，术后没有患者情况变差。未发现尺桡远侧关节融合不愈合或切除的尺骨段出现骨再生。良好的结果得益于严格遵循适应证：腕关节无既往存在的关节炎。
