Hemiresectional Arthroplasty in Rheumatoid Distal Radio-ulnar Joint – 3 to 6 years Results of Prospective Consecutive Series - |
Kwang-Hyun Lee, Joung-Uck Na, Hoon Yeo, Yun-Jae Kim |
류마토이드 원위 요척 관절의 반절제 관절 성형술 - 3년에서 6년 전향적 추시 결과 - |
이광현, 나정욱, 여훈, 김윤재 |
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Abstract |
Purpose : The clinical results from at least 3 to 6 years of the hemiresectional arthroplasty on rheumatoid arthritis patients who suffered from destruction of the distal radioulnar joint were reviewed. Materials and Methods : Out of the patients who had hemiresectional arthroplasty in our hospital between from Jan. 1995 and August 1998, 32 cases have been selected. Average follow-up periods were 51 months(range, 37~74 months). Hemiresectional arthroplasty together with synovectomy and tenosynovectomy was done in all patients, and in 19 cases of extensor tendon rupture, tendon graft(12 cases) or tendon transfer(17 cases) was performed. The patients were evaluated by both visual analogue scale and rating scale of the Hospital For Special Surgery. Results : During the period of follow-up, pain was eased or radicated in 30 cases(94%) and 27 patients(85%) were satisfied with the operation results. However, weakening of grip in 31 cases showed its improvement in only 19 cases (61%). The pronation-supination angle has improved to 70 and 69 degrees on average at the time of the last follow up, whereas it was measured by 35 and 25 degrees prior to the operation. Analysis based on the rating scale of the Hospital for Special Surgery showed a clinical result better than fair in 28 cases(86%), which includes 15 excellent cases, 5 good cases, and 8 fair cases. Five cases of 19 who were treated by tendon graft(2 cases) or tendon transfer(17 cases) due to rupture of extensor tendon, showed extensor lag but no further extensor rupture. Conclusion : The hemiresectional arthroplasty of distal radioulnar joint on rheumatoid arthritis patients resulted in material reduction of pain, function restoration, and overall improvement in stability of distal radioulnar joint. The hemiresectional arthroplasty is also considered effective surgical modality in rheumatoid arthritis patients, involving distal radioulnar joint. |
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