Sauvé-Kapandji术治疗陈旧性下尺桡关节掌侧脱位  

Treatment of obsolete volar dislocation of the distal radioulnar joint by Sauvé-Kapandji procedure

作　　者：王谦[1] 王建东[1] 高伟[1] 李凡[1] 汪方[1] 王秋根[1] 黄建华[1] 

机构地区：[1]上海交通大学附属第一人民医院骨科,201620

出　　处：《中华创伤骨科杂志》2014年第7期565-569,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的 探讨应用Sauvé-Kapandji术治疗陈旧性下尺桡关节（DRUJ）掌侧脱位的疗效.方法 回顾性分析2008年3月至2012年3月采用Sauvé-Kapandji术治疗的3例陈旧性DRUJ掌侧脱位患者资料,男2例,女1例;平均年龄45岁（35 ～51岁）.3例患者均表现为腕关节旋转受限和疼痛.术前行X线检查、CT三维重建明确诊断并制定相应手术方案.术后采用疼痛视觉模拟评分量表（VAS）评分、关节活动度测量、肩臂手功能丧失量表（DASH）评分、Mayo肘关节功能评分（MEPS）及握力测量评定疗效. 结果 3例患者术后获1.5 ～3.0年（平均2.3年）随访.脱位均得以纠正,未出现尺骨近端不稳末次随访时疼痛VAS评分由术前平均5.3分改善至2.0分;腕关节屈曲活动度由术前平均29.3°改善至60.7°,背伸活动度由术前平均26.0°改善至53.7°,桡偏活动度由术前平均11.7°改善至19.0°,尺偏活动度由术前平均7.0°改善至17.7°;DASH评分由术前平均33分改善至73分,MEPS评分由术前平均41分改善至82分;患侧手的握力与健侧百分比由术前平均29.3％恢复至72.7％.结论 Sauvé-Kapandji术作为一种保留尺骨头及三角软骨复合体的术式,对DRUJ掌侧脱位是一种良好的治疗选择.Objective To evaluate the Sauvé-Kapandji procedure in the treatment of obsolete volar dislocation of the distal radiounlar joint （DRUJ）.Methods From March 2008 to March 2012,we treated 3 patients with obsolete DRUJ volar dislocation using the Sauvé-Kapandji procedure.They were 2 men and one woman,with an average age of 45 years （from 31 to 45 years）.They all presented with limited rotation of the wrist and pain.The surgical protocol was developed after the diagnosis was confirmed by X-ray and 3D-CT scan before operation.The clinical outcomes were assessed postoperatively by visual analogue scale （VAS） score,range of motion （ROM） of the wrist,grip strength,Disabilities of the Arm,Shoulder and Hanl （DASH） and Mayo scores.Results The 3 patients were followed up for 1.5 to 3.0 years （2.3 years on average）.Their dislocation was corrected with no occurrence of instability of the proximal ulna.The VAS score decreased from preoperative 5.3 points to postoperative 2.0 points.The wrist flexion increased from preoperative 29.3° to postoperative 60.7°,the wrist extension from preoperative 26.0° to postoperative 53.7°,the radial deviation from preoperative 11.7° to postoperative 19.0°,the ulnar deviation from preoperative 7.0° to postoperative 17.7°,the DASH score from preoperative 33 points to postoperative 73 points,the Mayo score from preoperative 41 points to postoperative 82 points,and the grip strength from preoperative 29.3 ％ to postoperative 72.7％ of the healthy side.Conclusion Sauvé-Kapandji procedure is a fine treatment of DRUJ volar dislocation,because it leads to satisfactory clinical outcomes in addition to preservation of the ulnar head and triangular fibrocartilage complex.

关 键 词：腕关节 脱位 活动范围 关节 握力 Sauvé-Kapandji术 

分 类 号：R687.4[医药卫生—骨科学]