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MR Vol.14 No.1 indexに戻る
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MODERN RHEUMATOLOGY
Vol.14 No.1 |
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Radiological follow-up study of rheumatoid wrists
after radio-lunate limited arthrodesis with ulnar head resection |
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| Kensuke Uchida1, Keiichiro Nishida1 , Hiroyuki
Hashizume1, Shunsuke Omoto1, Masutaka Watanabe1, Yusuke Ota1 and
Hajime Inoue1 |
| (1) Study of Biofunctional Recovery and Reconstruction,
Okayama University Graduate School of Medicine and Dentistry, 2-5-1
Shikata-cho, Okayama, 700-8558, Japan |
Received: 10 March 2003 Accepted: 30 June 2003 |
| Abstract |
| Abstract Radio-lunate limited arthrodesis (RLA)
is an established surgical intervention for damaged rheumatoid arthritis
(RA) wrists. The goal of RLA is to conserve the range of motion (ROM)
and level of activities of daily life (ADL) by delaying more extensive
fusion. In this study, we retrospectively reviewed the outcome of
RLA with ulnar head resection (UHR) in terms of pain score, ROM,
and radiographic parameters, including carpal height ratio, ulnar
translation ratio, and palmar subluxation. The clinical factors,
such as dose of corticosteroids per day and laboratory examination
data before surgery, including C-reactive protein (CRP), erythrocyte
sedimentation rate (ESR), and rheumatoid factor (RF), did not influence
the results of the surgery. The changes in these clinical factors
were also statistically analyzed in relation to the Schulthess classification
of preoperative radiographs of wrists reported by Simmen and Huber:
Type I (ankylosis type), Type II (osteoarthritis type), and Type
III (disintegration type). This study hypothesized that RLA with
UHR would provide no significant improvement in Type III wrists.
The results showed that RLA with UHR resulted in stable wrists with
excellent pain relief and with limited, but temporary, functional
ROM, suggesting that this procedure seems to be applicable for all
types of wrists within this group of patients. |
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| Key words |
| Key words Arthrodesis - Radiography - Rheumatoid
arthritis (RA) - Wrist joint |
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