Radiolunate and radioscapholunate arthrodeses as treatments for rheumatoid and psoriatic arthritis: long-term follow-up.
| Autor: | Raven EE; Department of Orthopaedic Surgery and Traumatology, Gelre Hospital, Apeldoorn, The Netherlands. e.raven@gelre.nl, Ottink KD, Doets KC |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of hand surgery [J Hand Surg Am] 2012 Jan; Vol. 37 (1), pp. 55-62. Date of Electronic Publication: 2011 Dec 03. |
| DOI: | 10.1016/j.jhsa.2011.10.012 |
| Abstrakt: | Purpose: We evaluated long-term results for radiolunate and radioscapholunate arthrodeses for patients with rheumatoid or psoriatic arthritis to determine the durability and efficacy of the procedures. The results are described and compared with those in the literature. Methods: We carried out arthrodesis of the radiolunate joint (33 wrists) and the radioscapholunate joint (13 wrists) to achieve pain reduction and ulnar translation of the carpus in patients with rheumatoid (42 wrists) or psoriatic arthritis (4 wrists). At follow-up, 11 patients (13 wrists) had died, 2 patients (4 wrists) were lost to follow-up, and in 6 wrists an additional midcarpal arthrodesis had been performed. We evaluated the remaining 23 wrists (19 radiolunate and 4 radioscapholunate, and 1 psoriatic arthritic wrist) after a mean of 11 years. Results: Clinical outcome was good, with a mean visual analog score of 2 out of 10 for pain, mean grip strength of 13 kg, and mean range of flexion-extension of 60°. Outcomes as measured by questionnaires were good. Radiographs demonstrated deterioration of all intracarpal joints as noted by an increased Larsen score and evidence of carpal translation. We noted no significant change in carpal height. Conclusions: Despite radiographic progression, radiolunate and radioscapholunate arthrodeses yield good clinical results at long-term follow-up. Type of Study/level of Evidence: Therapeutic IV. (Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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