| Radiololgic Measurement of Carpal Height and Ulnar Translation for the Value of the Radiolunate Fusion in the Rheumatoid Wrist |
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Seong-Pil Lee, Joo-Hak Kim, Kwang-Hyun Lee, Woo-Sung Jung |
| 류마토이드 수근 관절염에서 요-월상골 유합술의 필요여부를 평가 하기 위한 수근 높이 및 척측 전위의 방사선학적 측정 |
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이성필, 김주학, 이광현, 정우성 |
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| Abstract |
Purpose
Radiolunate fusion in the rheumatoid wrist have reported that it gave good clinical results for decrease in carpal height change and recurrence of carpal translation. We measured interval changes of carpal height and ulnar translation in rheumatoid patients who had not received the operation on the wrist and then want to know the value of radiolunate fusion. Materials and Methods: We evaluated 41 patients (80 cases) who had visited our hospital due to rheumatoid arthritis between 1995 and 1999 with at least 5 years follow-up radiographs. We measured Youm index for carpal height and Chamay index for ulnar translation. We analyzed their changes in wrist posteroanterior radiographs between initial and last follow-up. The Student’s t-test was used for the statistical analaysis. Results: Difference in Larsen grade between initial and final radiograph is 0.8. The changes in ulnar translation index (by Chamay method) are average 0.018 and the changes in carpal height index (by Youm method) are average 0.042. Carpal height index change is significantly different, especially between grade I, II and III, IV (P value=0.003). But, ulnar translation index change is not significant. Conclusion: Radiolunate fusion is not always necessary as a supplementary procedure to wrist synovectomy in Larsen grade II to IV. Our series suggest that radiolunate fusion should be applied only in limited cases of rheumatoid wrist. |
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