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MR Vol.14 No.3 indexに戻る
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MODERN RHEUMATOLOGY
Vol.14 No.3 |
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Usefulness of interposition arthroplasty in the
Sauve?Kapandji procedure for rheumatoid wrist |
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| Nobuyuki Tanaka1 , Hisashi Sakahashi1, Kazuya
Hirose1, Takumi Ishima1 and Seiichi Ishii2 |
(1) Sapporo Gorinbashi Orthopedic Hospital in
Gorinbashi Hospitals, 2-1 Kawazoe, Minami-ku, Sapporo, 005-0802,
Japan
(2) Department of Orthopedic Surgery, School of Medicine, Sapporo Medical University,
Sapporo, Japan |
Received: 18 September 2003 Accepted: 28 January
2004 |
| Abstract |
| The aim of synovectomy combined with the Sauve?Kapandji
(S?K) procedure for the treatment of a rheumatoid wrist is to obtain
a stable painless wrist that retains sufficient mobility for function.
However, loss of motion occurs postoperatively in most cases. In
our study of 59 rheumatoid patients, the results of the transposition
of distal strips of retinaculum into the radiocarpal and ulnocarpal
joints for interposition arthroplasty to maintain wrist motion (interposition
group), and transposition below the extensors to provide a gliding
surface (SK group) were evaluated. The distal end of the ulna was
fixed to the radius with poly-L-lactic acid screws, and a proximal
strip of retinaculum was placed above the extensors after synovectomy
of the rheumatoid wrist. Clinical symptoms, radiographic changes,
and postoperative complications were assessed 3?9 years (mean 5.9
years) postoperatively. Patients in the interposition group showed
better postoperative results, including wrist motion, than those
of patients in the SK group. Both procedures resulted in only minor
complications such as superficial skin necrosis, hematoma, and superficial
infection. We concluded that interpostion arthroplasty combined with
the S?K procedure using a distal strip of retinaculum might be a
safe and appropriate method for wrist reconstruction following synovectomy
of a rheumatoid wrist. |
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| Key words |
| Interposition arthroplasty - Poly-L-lactic acid
(PLLA) screw - Retinaculum - Rheumatoid wrist - Sauve?Kapandji (S?K)
procedure |
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