Objective: To evaluate the effectiveness of Sauvé-Kapandji procedure in the treatment of traumatic ulnar styloid impaction syndrome.
Methods: Between June 2010 and January 2013, 12 patients with traumatic ulnar styloid impaction syndrome were treated by Sauvé-Kapandji procedure. There were 4 men and 8 women, with an average age of 58.9 years (range, 50-69 years). The disease was caused by traffic accident in 1 case, and by falling from height in 11 cases. All patients had dislocation of the distal radioulnar joint, and 7 patients also had old fractures of the distal radius. The main clinical symptoms were pain and limited activity of the wrist joint, and the disease duration was 2-4 months (mean, 3.5 months). The visual analogue scale (VAS) was 6.2±1.4. The clinical outcomes were assessed by VAS, range of motion (ROM) of the wrist, grip strength, Evans score, and X-ray film of wrist joint during follow-up.
Results: All patients obtained healing of incision by first intention and were followed up 37-73 months (mean, 58.4 months); no complication of infection, blood vessel injury, or nerves injury occurred. VAS was 1.2±1.0 at the final follow-up, showing significant difference when compared with preoperative one ( t=9.950, P=0.000). The ROM of the affected wrist joint in flexion, extension, ulnar deviation, forearm pronation and supination were improved, but the ROM of the affected side were significantly less than those of normal side ( P<0.05). No significant difference was found in the grip strength and Evans score between the affected side and normal side ( t=-0.885, P=0.386; t=-1.969, P=0.062). According to Evans scores, the results were excellent in 8 cases, good in 3 cases, and fair in 1 case, with an excellent and good rate of 91.7%. Postoperative radiographs showed bony healing in all patients, with the average healing time of 3.5 months (range, 3-6 months). The instability of proximal ulna occurred in 3 cases.
Conclusion: Sauvé-Kapandji procedure is a reliable remedy method for traumatic ulnar styloid impaction syndrome, with favorable improvement in wrist pain and forearm rotation. However, the surgical indications for Sauvé-Kapandji procedure should be strictly controlled.
目的: 探讨Sauvé-Kapandji术治疗创伤性尺骨茎突撞击综合征的临床疗效。.
方法: 2010 年 6 月–2013 年 1 月，采用 Sauvé-Kapandji 术治疗12例创伤性尺骨茎突撞击综合征患者。男 4 例，女 8 例；年龄 50～69 岁，平均 58.9 岁。致伤原因：交通事故伤 1 例，摔伤 11 例。患者均有下尺桡关节脱位，其中 7 例合并桡骨远端陈旧性骨折。主要临床症状为腕尺侧疼痛伴功能受限；疼痛视觉模拟评分（VAS）为（6.2±1.4）分。病程 2～4 个月，平均 3.5 个月。术后采用 VAS 评价腕关节疼痛程度，记录腕关节活动度、握力、Evans 评分，摄腕关节 X 线片观察。.
结果: 术后切口均Ⅰ期愈合，无感染及神经、血管损伤等相关并发症发生。12 例患者均获随访，随访时间 37～73 个月，平均 58.4 个月。末次随访时，腕关节VAS评分为（1.2±1.0）分，与术前比较差异有统计学意义（ t=9.950， P=0.000）。患侧腕关节掌屈、背伸、尺偏以及前臂旋前、旋后活动度均明显改善，但仍显著低于健侧（ P＜0.05）；握力及腕关节功能Evans评分与健侧比较，差异均无统计学意义（ t=–0.885， P=0.386； t=–1.969， P=0.062）。腕关节功能评分获优 8 例，良 3 例，中 1 例，优良率 91.7%。X 线片复查示，下尺桡关节均获骨性融合，融合时间 3～6 个月，平均 3.5 个月。3 例出现尺骨截骨处尺骨近端不稳。.
结论: 对于创伤性尺骨茎突撞击综合征，Sauvé-Kapandji 手术是一种可靠补救方法，术后患者腕关节疼痛有效缓解，前臂旋转功能得到较大改善，但需要严格把握手术适应证。.
Keywords: Sauvé-Kapandji procedure; Ulnar styloid impaction syndrome; functional reconstruction; wrist.