Handgelenksynovektomie und radiokarpale Stabilisierung durch Sehnentransfer

Dinges, H.; Thabe, H.

doi:10.1007/bf02510186

Cited by 3 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Der zu beklagende Bewegungsverlust liegt bei akzeptalen 40-60% gegenüber der Ausgangssituation. Somit verbleibt den Patienten eine für die Verrichtung der Alltagsfunktion ausreichende Beweglichkeit bei Zunahme von Kraft und Stabilität [5,9,20].…”

Section: > Bei Ulnarer Oder Volarer Dislokation Sollten Knöcherne Staunclassified

“…Um dieser drohenden ulnovolaren Instabilität entgegen zu wirken, bieten sich in den frühen bis mittleren Stadien ohne bereits eingetretene Dislokation und Destruktion im radiokarpalen Gelenkabschnitt dynamische Stabilisationsverfahren an [4,9,10]. Dinges u. Thabe [9] berichteten 1996 über eine radiokarpale Stabilisierung durch Verlagerung der ulnaren Hälfte des Extensor carpi radialis brevis in den distalen Anteil der Sehne des Extensor carpi ulnaris (.…”

Section: Introductionunclassified

“…Dinges u. Thabe [9] berichteten 1996 über eine radiokarpale Stabilisierung durch Verlagerung der ulnaren Hälfte des Extensor carpi radialis brevis in den distalen Anteil der Sehne des Extensor carpi ulnaris (. Abb.…”

Section: Introductionunclassified

See 2 more Smart Citations

Operative Differenzialtherapie des rheumatischen Handgelenks

et al. 2007

View full text Add to dashboard Cite

The wrists are affected in the long-term in 90% of people with rheumatism and are often (42%) the first manifestation of a destructive disease. The functionality of the wrist and the whole hand is of great importance because in many cases loss of function of the wrists leads to severe limitations. Local and operative treatment of the wrist in rheumatoid arthritis (RA) is one of the main duties in rheuma-orthopaedics. For operative treatment there is a finely tuned differential therapeutic spectrum available. The diagnostic indications take the local and total pattern of affection, the current systemic therapy as well as patient wishes and patient compliance into consideration. In the early stages according to LDE (Larsen, Dale, Eek), soft tissues operations such as articulo-tenosynovectomy (ATS) are most commonly carried out. In further advanced stages osseus stabilisation must often be performed. At this point a smooth transition from partial arthrodesis to complete fixation is possible. After initial euphoria, arthroplasty of the wrist is being increasingly less used for operative treatment due to the unconvincing long-term results and high complication rate. With reference to the good long-term results of all operative procedures, in particular early ATS with respect to pain, function and protection of tendons, after failure of medicinal treatment and persistence of inflammatory activity in the wrist, patients should be transferred to an experienced rheuma-orthopaedic surgeon.

show abstract

Section: > Bei Ulnarer Oder Volarer Dislokation Sollten Knöcherne Staunclassified

Section: Introductionunclassified

See 1 more Smart Citation

Operative Differenzialtherapie des rheumatischen Handgelenks

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Als therapeutische Konsequenz wird von den meisten Autoren (8,16,20,23,35) die Kombination aus Ulnaköpfchenresektion und partieller radiokarpaler Arthrodese empfohlen. Alternative Therapiestrategien umfassen die kapsuloligamentäre Stabilisierung mit Sehnentransfer (6,10,14) oder die Sauvé-Kapandji Operation (31). Entscheidendes Kriterium für die Wahl des karpalen Stabilisierungsverfahrens nach Ulnaköpfchenresekti-on ist der zu erwartende Spontanverlauf und das Ausmaß der radiokarpalen Gelenkdestruktion nach Larsen, Dahle und Eek (22).…”

Section: Introductionunclassified

Die radioulnäre Teilarthrodese zur Stabilisierung des rheumatischen Handgelenkes

Schill

Lühr²,

Thabe³

2002

Zeitschrift f�r Rheumatologie

View full text Add to dashboard Cite

Late Synovectomy of the rheumatoid wrist combined with ulna head resection and dorsal wrist stabilization will not prevent carpal instability and dislocation. Depending on the radiological destruction pattern and the natural course of the wrist according to Simmen, dorsal wrist synovectomy is combined with soft-tissue or osseus stabilization procedures.This article describes the mid- and long-term results of radio-lunate arthrodesis in patients with rheumatoid arthritis. We present a retrospective study of 69 radiolunate arthrodesis performed from 1988 to 1994. Fifty patients with 57 wrists were available for clinical and radiological follow-up. All patients were suffering from rheumatoid arthritis (dominating female). The average length of R.A. illness was 9.6 years. The mean age at operation was 54.4 years. Postoperative results were reviewed with the Clayton score. The radiographic analysis included measurement of the carpal height index and ulnar translation of the carpus. The follow-up period ranged from 4 to 10.8 years (average: 7 years). The postoperative Clayton score averaged 74.2 points, representing 70% good or excellent results. Twelve wrists achieved satisfactory results and five were judged poor. The most benefit was achieved in pain relief and restoration of wrist function and extensor strength. Complete pain relief was achieved in 36 wrists, while 16 reported slight pain from loads. Five patients still complained about pain with daily wrist activity. We noticed a moderate decrease for extension-flexion (-39 degrees ) and for combined ulnar-radial deviation (-10 degrees ). The radiographic analysis proved stabilization of ulnar translocation in most cases. We routinely noticed a moderate radiographic progression according to the Larsen classification (+0.7) with reduction of the carpal height ratio. In conclusion radioulnate arthrodesis proved satisfactory pain relief and maintenance of functional wrist motion. Despite radiographic deterioration, partial wrist arthrodesis restrains ulnar translocation, while stabilization of the rheumatoid wrist is achieved.

show abstract