Differenzialindikation der dorsalen Kapsulodese und der STT-Arthrodese bei Patienten mit einer skapholunären Dissoziation. Ist das Ergebnis abhängig von der Diagnose oder dem Operationsverfahren?

Autor:	M. Meyer-Marcotty, M. Flügel, T. Bahr, J. Redeker, J. Hankiss
Rok vydání:	2005
Předmět:	Dorsum medicine.medical_specialty medicine.diagnostic_test business.industry Arthrodesis medicine.medical_treatment Physical examination Surgery Carpal instability Scapholunate dissociation Postoperative results medicine Orthopedics and Sports Medicine In patient business Range of motion
Zdroj:	Handchirurgie · Mikrochirurgie · Plastische Chirurgie. 37:97-105
ISSN:	1439-3980 0722-1819
Popis:	BACKGROUND Dorsal capsulodesis and triscaphe arthrodesis are possible treatment modalities for patients with scapholunate dissociation. In light of overlapping indications for either operation for patients with carpal instability, it is important to compare the postoperative results. METHODS From 1998 until 2002, we operated on 87 patients suffering from scapholunate dissociation. 52 patients were treated by dorsal capsulodesis after R. Berger and 35 patients were treated by triscaphe arthrodesis as published by Watson. Of these 87 patients, we managed to follow-up 77 patients (47 dorsal capsulodesis und 30 triscaphe arthrodesis) with a physical examination, X-ray of the wrists and Krimmer Score. RESULTS In terms of grip-strength, range of motion, functional outcome (Krimmer Score), duration of the operation and hospitalisation, the dorsal capsulodesis group performed better (p < 0.05) than the triscaphe arthrodesis group at the time of follow-up. At follow-up, pain reduction was significant in both groups (p < 0.05). Krimmer Score (functional outcome) and the rate of complication was clearly better for the dorsal capsulodesis group as compared to the triscaphe arthrodesis group. CONCLUSION In case of non-static scapholunate dissociation, dorsal capsulodesis should be the first choice treatment. In case of a young manually working man with static scapholunate dissociation, it should be a case-to-case decision whether performing a triscaphe arthrodesis or a dorsal capsulodesis. With this investigation we wanted to discuss and demonstrate the difficulties with the differential-indication for the two operations. Generally speaking the postoperative results did not depend on the type of scapholunate dissociation (dynamic versus static) but rather on the chosen surgical procedure.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::eb628a30b4bf0acd1afee5b5292dd113 https://doi.org/10.1055/s-2004-821281 Zobrazit plný text záznamu