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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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Clinical and radiological manifestations of the
rheumatoid wrist after the Sauve?Kapandji procedure |
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| Shigeki Momohara1 , Kyoko Mamizuka1, Kouichi
Yonemoto1, Taisuke Tomatsu1 and Kazuhiko Inoue2 |
(1) Department of Orthopaedic Surgery, Institute
of Rheumatology, Tokyo Womens Medical University, 10-22 Kawada-cho,
Shinjuku-ku, Tokyo, 162-0054, Japan
(2) Department of Orthopaedic Surgery, Daini Hospital, Tokyo Womens Medical University,
Tokyo, Japan |
Received: 06 November 2003
Accepted: 02 February 2004 |
| Abstract |
| A retrospective study was performed to investigate
the clinical and radiological results of the Sauve?Kapandji (S?K)
procedure for the rheumatoid wrist. One hundred and eight rheumatoid
wrists in 98 patients were operated on in our institute from 1992
to 2000, and in 82 wrists we used the S?K procedure. In other cases,
synovectomy alone was performed on 16 wrists, and partial and total
arthrodeses were performed concurrently on 5 wrists each. Carpal
bones and/or radiocarpal joints in which the union could not be assessed
radiologically were found in 49 wrists (59.8%) after the S?K procedure,
and among them there was definite nonfusion of the carpal bone and
radiocarpal joints in 29 wrists (35.4%). However, definite fusion
of carpal bones and/or radiocarpal joints was found in 33 wrists
(40.2%). The formation of carpal bones and partial radiocarpal fusion
with some mobility was detected in some cases. Therefore, the S?K
procedure may stabilize the carpus in the rheumatoid wrist to some
extent while maintaining a functionally important range of motion
and relieving pain. However, it does not stop the disease process
and cannot reestablish or maintain carpal height. We concluded that
the S?K procedure is the treatment of choice for the rheumatoid wrist,
and if the wrist is unstable, as seen with arthritis mutilans, we
then perform either radiolunate partial arthrodesis or total wrist
arthrodesis. |
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| Key words |
| Arthrodesis - Rheumatoid wrist - Sauve? Kapandji
(S?K) procedure - Synovectomy |
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