関節リウマチ患者の手指伸筋腱皮下断裂に対する治療
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概要
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Extensor tendon ruptures in the hands of patients with rheumatoid arthritis are treated by tendon transfer and/or tendon grafting. Various methods of reconstruction are performed on the rheumatoid wrist joints after synovectomy. One of these is the Sauve-Kapandji procedure, which is used to form a shelf with the excised ulnar head and a partial wrist arthrodesis after ulnar head excision. However, there are some associated problems, such as instability at the edge of the ulna and ulnar drift deformity of the carpal bones after ulnar head excision. The latter problem cannot be prevented by the Sauve-Kapandji procedure, and the wrist joint may be stiff after partial wrist arthrodesis.We report the results of our series, and discuss the indications for reconstruction.【Object and method】We examined its 11 sample 12 hands that had been experienced between April, 2006 and June, 2009. After ulnar head excision we did synovectomy, and used the Sauve-Kapandji procedure or a partial wrist arthrodesis together with the case where it has misgivings about the instability of the wrist joint after operation.【Result】Most hands regained the progress function, and were able to keep the winding function. The joint with the pain hardly was kept though the movable region limitation was left in the wrist joint as a result of the operation. For some cases, limitation of movable region remained after a partial wrist arthrodesis. Therefore, it is necessary to note us for the selection of method of operating.
- 中国・四国整形外科学会の論文
中国・四国整形外科学会 | 論文
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