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MR Vol.12 No.2 indexに戻る
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MODERN RHEUMATOLOGY
Vol.12 No.2 |
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Usefulness of absorbable screws in the Sauve-Kapandji
procedure for rheumatoid wrist reconstruction |
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| K. Nakamura1, H. Oda1, S. Tanaka1, Y. Kuga1,
M. Yamamoto1, T. Nishikawa1, T. Juji1, M. Shimizu1 |
| (1)Department of Orthopaedic Surgery, University
of Tokyo, 3-7-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan |
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| Abstract |
| Abstract In the Sauve-Kapandji (S-K) procedure
for rheumatoid wrist reconstruction, the distal end of the ulna
is fixed to the radius with screws. Recently, absorbable screws
have increasingly been used instead of metal ones. However, the
clinical usefulness of absorbable screws in S-K procedures for
rheumatoid patients is still unknown. The purpose of this article
is to evaluate the effect of absorbable screws in this procedure
by comparing their clinical results with those of metal screws.
Poly-l-lactic acid (PLLA) absorbable screws were used in 23 wrists,
and metal screws were used in 20 wrists. We evaluated the presence
of general or local reactions to PLLA, the stability of the ulnar
head, the time to bone union, changes in the shape of the distal
ulna, and the presence of bone resorption around the screws. There
were no complications with the use of PLLA screws, and their fixation
stability was adequate to form sufficient bone union. In five cases
in the metal screw group, bone resorption around the screws occurred
between 1 and 2 years after surgery. Bone resorption around the
PLLA screws was not observed. We conclude that absorbable screws
may be more useful than metal screws in the S-K procedure for rheumatoid
wrist reconstruction. |
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| Key words |
| Key words Absorbable screw ・ Poly- l -lactic acid (PLLA) ・ Rheumatoid
arthritis ・ Sauve-Kapandji (S-K) procedure ・ Wrist reconstruction |
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