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MR Vol.13 No.3 indexに戻る
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MODERN RHEUMATOLOGY
Vol.13 No.3 |
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Comparison of the SauvE-Kapandji procedure and
the Darrach procedure for the treatment of rheumatoid wrists |
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| Natsuko Nakagawa1 , Shuji Abe1, Hiroshi Kimura1,
Shigeaki Imura1, Yasuro Nishibayashi2 and Sinichi Yoshiya3 |
(1) Department of Orthopaedic Surgery, Konan
Kakogawa Hospital, 1545-1 Saijo, Kanno-cho, Kakogawa, 675-8545,
Japan
(2) Department of Orthopaedic Surgery, Miki?Sanyo Hospital, Miki, Japan
(3) Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine,
Kobe, Japan |
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| Received: 13 November 2002 Accepted: 25 December
2002 |
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| Abstract |
| In surgical treatment of the rheumatoid wrist,
the Darrach procedure combined with synovectomy has been the treatment
of choice in the past. However, owing to the significant ulnar carpal
shift observed after the Darrach procedure, the SauvE?Kapandji (S?K)
procedure has become increasingly popular. The purpose of this study
was to compare the clinical results of the S?K and Darrach procedures.
Thirty-two wrists in the S?K-procedure group and 31 wrists in Darrach-procedure
group were examined. Before and after surgery, clinical evaluations
of pain, swelling, range of motion, grip strength, and radiological
findings were performed and the results were compared. Both procedures
resulted in decreased pain and swelling, as well as improved rotatory
motion of the forearm. The S?K procedure was shown to be superior
to the Darrach procedure in reducing ulnar carpal migration and improving
grip strength. On the other hand, the prevention of carpal bone destruction
could not be completely achieved in either procedure. |
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| Key words |
| Darrach procedure - Rheumatoid arthritis (RA)
- SauvE?Kapandji (S?K) procedure - Synovectomy |
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