Gellman H, Hontas R, Brumfield R H, Tozzi J, Conaty J P
Department of Orthopaedic Surgery, University of Arkansas, Little Rock 72205, USA.
Clin Orthop Relat Res. 1997 Sep(342):71-6.
Fourteen total wrist arthroplasties performed in 13 patients with rheumatoid arthritis between 1978 and 1982 were reviewed to evaluate long term outcome. Most patients had Stages III or IV rheumatoid arthritis at the time of surgery. Pain was the primary presenting complaint in 87%. Average followup was 6.5 years (range, 3.5-11.5 years). Pain relief was achieved in 86% of patients. Using objective data obtained from their wrist scores, 72% of the patients had a good result, 14% had a fair result, and 14% had a poor result. No patient had an excellent result. Twenty-seven percent suffered postoperative complications related to their surgical procedure. Although these results help confirm the usefulness of total wrist arthroplasty as an alternative to arthrodesis of the wrist, it is a technically demanding procedure, and should be reserved for the patient who has severely involved arthritis. Additional improvements are needed to decrease the currently high complication and failure rate.
回顾了1978年至1982年间为13例类风湿性关节炎患者实施的14例全腕关节置换术，以评估其长期疗效。大多数患者在手术时处于类风湿性关节炎III期或IV期。87%的患者主要主诉为疼痛。平均随访时间为6.5年（范围3.5 - 11.5年）。86%的患者疼痛得到缓解。根据腕关节评分获得的客观数据，72%的患者效果良好，14%的患者效果尚可，14%的患者效果较差。没有患者效果极佳。27%的患者出现与手术相关的术后并发症。尽管这些结果有助于证实全腕关节置换术作为腕关节融合术替代方法的有效性，但这是一项技术要求很高的手术，应仅用于患有严重关节炎的患者。需要进一步改进以降低目前较高的并发症和失败率。
