Ocena wyników leczenia pourazowych uszkodzeń stawu promieniowo-łokciowego dalszego
The distal radioulnar joint (DRUJ) is functionally connected with the proximal radioulnar joint and structurally separated from the carpal joint. Thus provides pronation and supination in every position of the hand to the forearm. Posttraumatic lesions of the DRUJ permanently reduce its movability affecting personal and professional life comfort. We examined 27 patients (22 females and 5 males) with average age of 48 (14-89) treated in The Department of Orthopedic Surgery of The Medical University of Gdańsk between May 1994 and August 2005. The most common reason for hospitalization was subluxation or luxation of the DRUJ (n=17), another was isolated injury of the triangular fibrocartilage complex – TFCC (n=6) and degenerative changes in DRUJ (n=4). According to the kind of injury different types of operations were performed: Darrach procedure, Bowers procedure, partial resection of TFCC, resection of pseudoarthrosis of ulnar styloid process and fixation modo Weber, reconstruction of ulnocarpal collateral ligament. In the study the age and sex of the patients were analyzed. Functional evaluation was performed using the modified Mayo Wrist Scoring System (MWSS) and gave us mean score 62.2 points. The suggestion for better results is using more successful operating methods such: Sauve Kapandji procedure, shortening of the ulna, reconstruction of both dorsal and volar radioulnar ligaments and carpal arthroscopy. Our study showed that the age has a significant influence on the treatment results: the younger the patients the better outcomes in Mayo score and in patients’ opinion. We stated that there are no statistically important differences between Darrach and Bowers procedures in relation to the observed factors: range of motion before and after the operation, grip strength before and after the operation, pain, work capacity, and results using Cooney’s score.
Adres: dr med. Adam Lorczyński
Klinika Chirurgii Ręki AMG