Sauvé-Kapandji手术治疗下尺桡关节脱位和关节炎

The treatment of distal radioulnar joint dislocation and arthritis by Sauvé-Kapandji

目的:评价Sauvé-Kapandji手术治疗下尺桡关节脱位和关节炎的临床疗效。方法:Sauvé-Kapandji手术治疗下尺桡关节脱位和关节炎患者12例,术后随访9～32个月,平均16个月,随访检查包括手术前后腕关节疼痛程度、腕关节活动度、握力以及术后患侧X线检查。X线检查观察下尺桡关节愈合及测量尺桡骨间距。Mayo腕关节评分法评价手术前后腕关节功能恢复程度,DASH问卷调查表行手术前后腕关节功能自我评价。结果:术前腕关节疼痛值在负重后为(39±17),术后疼痛值为(23±13)。尺桡偏活动度术前为(26°±11°),术后为(41°±12°);旋前旋后活动度术前为(84°±21°),术后为(139°±33°)。握力术前为(12.8±3.6)kg,术后为(24.0±7.4)kg。Mayo评分结果术前为(43±13),术后为(73±16),优3例,良4例,中3例,差2例。DASH值术前为(57±14),术后为(31±10)。X线检查12例下尺桡关节及尺骨移植处全部愈合。结论:Sauvé-Kapandji手术治疗下尺桡关节脱位和关节炎,疼痛明显减轻,旋转活动度和握力增加,功能明显改善。

Objective：To estimate the clinical effectiveness of Sauve-Kapandji technique for the treatment of distal radioulnar joint dislocation and arthritis. Methods： 12 cases of distal radioulnar joint dislocation and arthritis were treated by Sauve-Kapandji technique. All cases were followed up for 9-32 months,with an average of 16 months.Pre-and postoperative wrist pain degree, wrist range of motion, grip strength and X-rays of wrist were evaluated. According to X-rays,the distance between radius and ulna and radiological union were observed. The function of wrist was evaluated by Mayo scores. Self-evaluations of postoperative wrist function were evaluated by DASH questionnaire.Results：Wrist pain score was （39± 17） preoperatively as con]pared to （23± 13） postoperatively. The preoperative range of motion of ulnar and radial deviation was （26°±11°）, which postoperative was （41°±12°）;the preoperative range of rotation was （84°±21°）,which postoperative was （139°±33°）.The preoperative grip strength was （12.8±3.6） kg, which postoperative was （24.0±7.4） kg. The value of Mayo scores was （43±13） preoperative, which postoperative was （73±16）. Among the 12 cases, 3 cases was excellent, 4 was good, 3 was fair and 2 was poor. The preoperative DASH score was （57±14）, which postoperative was （31±10）. X-rays showed that all distal radioulnar joint and ulnar bone transplantation were completely union. Conclusion：After Sauve-Kapandji operation for pain is relieved, rotation range of motion and grip strength increased and wrist function was promoted.