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Therapieoptionen bei Arthrose des distalen Radioulnargelenks

Therapeutic options in the arthritic distal radioulnar joint

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Zusammenfassung

Die Arthrose des distalen Radioulnargelenks kann zu einer schmerzhaften Einschränkung der Unterarmdrehbewegung führen. Nach dem Versagen konservativer Therapiemethoden verbleiben an operativen Maßnahmen unterschiedliche Formen der Resektionsarthroplastiken, die Sauvé-Kapandji-Operation, die endoprothetische Versorgung und letztendlich auch die radioulnare Fusion mit Schaffen eines „one-bone forearm“ unter komplettem Verlust der Unterarmdrehbewegung. Die unterschiedlichen, möglichen Therapieoptionen werden unter Berücksichtigung der Biomechanik, der publizierten Ergebnisse, der Komplikationen und der Rückzugsmöglichkeiten diskutiert und ein Therapiealgorithmus wird vorgestellt.

Abstract

Arthritis of the distal radioulnar joint may lead to painful reduction of forearm rotation. If conservative treatment has failed, different kinds of resection arthroplasties, the Sauvé-Kapandji procedure or ulnar head replacements have been proposed. The last therapeutic option consists of radioulnar fusion (one-bone forearm) with complete loss of forearm rotation. Considering the literature, the biomechanics, the complications and the possible revision options the different procedures are discussed and a treatment algorithm is proposed.

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Literatur

  1. Axelsson P, Sollerman C (2013) Constrained implant arthroplasty as a secondary procedure at the distal radioulnar joint: early outcomes. J Hand Surg Am 38:1111–1118

    Article  PubMed  Google Scholar 

  2. Bauer D, Schweizer A, Nagy L (2015) Periprosthetic fracture of the ulna – a case report. J Wrist Surg 4:134–138

    Article  PubMed  Google Scholar 

  3. Bell MJ, Hill RJ, McMurtry RY (1985) Ulnar impingement syndrome. J Bone Joint Surg 67-B:126–129

    Google Scholar 

  4. Berger RA, Cooney WP III (2005) Use of an ulnar head endoprosthesis for the treatment of an unstable distal ulnar resection: review of mechanics, indications, and surgical technique. Hand Clin 21:603–620

    Article  PubMed  Google Scholar 

  5. Bowers WH (1985) Distal radioulnar joint arthroplasty: the hemiresection-interposition technique. J Hand Surg Am 10:169–178

    Article  CAS  PubMed  Google Scholar 

  6. Buck-Gramck D (1990) On the priorities of publications of some operative procedures on the distal end of the ulna. J Hand Surg Br 15:416–420

    Article  Google Scholar 

  7. Carter PB, Stuart PR (2000) The Sauve-Kapandji procedure for post-traumatic disorders of the distal radio-ulnar joint. J Bone Joint Surg 82-B:1013–1018

    Article  Google Scholar 

  8. Garcia-Elias M (2007) Eclypse: partial ulnar head replacement for the isolated distal radio-ulnar joint arthritis. Tech Hand Up Extrem Surg 11:121–128

    Article  PubMed  Google Scholar 

  9. Herzberg G (2010) Periprosthetic bone resorption and sigmoid notch erosion around ulnar head implants: a concern? Hand Clin 26:573–577

    Article  PubMed  Google Scholar 

  10. Jacoby SM, Bachoura A, DiPrinzio EV, Culp RW, Osterman AL (2013) Complications following one-bone forearm surgery for posttraumatic forearm and distal radioulnar joint instability. J Hand Surg Am 38:976–982

    Article  PubMed  Google Scholar 

  11. Kakar S, Swann RP, Perry KI, Wood-Wentz CM, Shin AY, Moran SL (2012) Functional and radiographic outcomes following distal ulna implant arthroplasty. J Hand Surg Am 37:1364–1371

    Article  PubMed  Google Scholar 

  12. Kakar S, Fox T, Wagner E, Berger R (2014) Linked distal radioulnar joint arthroplasty: an analysis of the APTIS prosthesis. J Hand Surg Eur 39:739–744

    Article  CAS  Google Scholar 

  13. Kopylov P, Tägil M (2007) Distal radioulnar joint replacement. Tech Hand Up Extrem Surg 11:109–114

    Article  PubMed  Google Scholar 

  14. Minami A, Suzuki K, Suenaga N, Ishikawa J (1995) Hemiresection-interposition arthroplasty for osteoarthritis of the distal radioulnar joint. Int Orthop 19:35–39

    Article  CAS  PubMed  Google Scholar 

  15. Minami A, Kaneda K, Itoga H (1991) Hemiresection-interposition arthroplasty of the distal radioulnar joint associated with repair of triangular fibrocartilage complex lesions. J Hand Surg Am 16:1120–1125

    Article  CAS  PubMed  Google Scholar 

  16. Sanders RA, Frederick HA, Hontas RB (1991) The Sauvé-Kapandji procedure: a salvage operation for the distal radioulnar joint. J Hand Surg Am 16:1125–1129

    Article  CAS  PubMed  Google Scholar 

  17. Sauder DJ, King GJ (2007) Hemiarthroplasty of the distal ulna with an eccentric prosthesis. Tech Hand Up Extrem Surg 11:115–120

    Article  PubMed  Google Scholar 

  18. Sauerbier M, Fujita M, Hahn ME, Neale PG, Berger RA (2002) The dynamic radioulnar convergence of the Darrach procedure and the ulnar head hemiresection interposition arthroplasty: a biomechanical study. J Hand Surg Br 27:307–316

    Article  CAS  PubMed  Google Scholar 

  19. Sauerbier M, Hahn ME, Fujita M, Neale PG, Berglund LJ, Berger RA (2002) Analysis of dynamic distal radioulnar convergence after ulnar head resection and endoprosthesis implantation. J Hand Surg Am 27:425–434

    Article  PubMed  Google Scholar 

  20. Savvidou C, Murphy E, Mailhot E, Jacob S, Scheker LR (2013) Semicontrained distal radioulnar joint prothesis. J Wrist Surg 2:41–48

    Article  PubMed Central  PubMed  Google Scholar 

  21. Scheker LR (2008) Implant arthroplasty for the distal radio-ulnar joint. J Hand Surg Am 33:1639–1644

    Article  PubMed  Google Scholar 

  22. van Schoonhoven J, Lanz U (1998) „Rund um den Ellenkopf“: Verletzungsmuster und Klassifikationen. Handchir Mikrochir Plast Chir 30:351–360

    PubMed  Google Scholar 

  23. van Schoonhoven J, Lanz U (2004) Rettungsoperationen und deren Differenzialindikation am distalen Radioulnargelenk. Orthopade 33:704–714

    Article  PubMed  Google Scholar 

  24. van Schoonhoven J, Prommersberger K-J, Lanz U (1999) Die Bedeutung des distalen Radioulnargelenkes bei rekonstruktiven Eingriffen nach fehlverheilten körperfernen Speichenfrakturen. Orthopade 28:864–871

    PubMed  Google Scholar 

  25. van Schoonhoven J, Kall S, Schober F, Prommersberger K-J, Lanz U (2003) Die Hemiresektions-Interpositionsarthroplastik als Rettungsoperation bei Arthrose des distalen Radioulnargelenkes. Handchir Mikrochir Plast Chir 35:175–180

    Article  PubMed  Google Scholar 

  26. van Schoonhoven J, Herbert TJ, Krimmer H (1998) Neue Konzepte der Endoprothetik des distalen Radioulnargelenkes. Handchir Mikrochir Plast Chir 30:387–392

    PubMed  Google Scholar 

  27. van Schoonhoven J, Mühldorfer-Fodor M, Fernandez DL, Herbert TJ (2012) Salvage of failed resection arthroplasties of the distal radioulnar joint using an ulnar head prosthesis: long-term results. J Hand Surg Am 37:1372–1380

    Article  PubMed  Google Scholar 

  28. van Schoonhoven J, Herbert TJ, Prommersberger KJ, Krimmer H (2003) Ulnakopfprothese. Orthopade 32:809–815

    Article  Google Scholar 

  29. Stanley D, Herbert TJ (1992) The Swanson ulnar head prosthesis for post-traumatic disorders of the distal radioulnar joint. J Hand Surg Br 17:682–688

    Article  CAS  PubMed  Google Scholar 

  30. Swanson AB (1973) Implant arthroplasty for disabilities of the distal radioulnar joint. Use of a silicone rubber capping implant following resection of the ulnar head. Orthop Clin North Am 4:373–382

    CAS  PubMed  Google Scholar 

  31. Wolfe SW, Mih AD, Hotchkiss RN, Culp RW, Kiefhaber TR, Nagle DJ (1998) Wide excision of the distal ulna. J Hand Surg Am 23:222–228

    Article  CAS  PubMed  Google Scholar 

  32. Zimmermann R, Gschwentner M, Arora R, Gabl M, Pechlaner S (2003) Klinische Langzeitergebnisse der Kapandji-Sauvé-Operation. Handchir Mikrochir Plast Chir 35:157–163

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik für Handchirurgie, Salzburger Leite 1, 97616, Bad Neustadt, Deutschland

    Jörg van Schoonhoven, Karl-Josef Prommersberger MD & Thomas Pillukat MD

Authors
  1. Jörg van Schoonhoven
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  2. Karl-Josef Prommersberger MD
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  3. Thomas Pillukat MD
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Correspondence to Jörg van Schoonhoven.

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Interessenkonflikt

J. van Schoonhoven und K.-J. Prommersberger sind als Referenten für die Firma KLS-Martin tätig und erhalten ein Beraterhonorar. T. Pillukat hat keinen Interessenkonflikt.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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van Schoonhoven, J., Prommersberger, KJ. & Pillukat, T. Therapieoptionen bei Arthrose des distalen Radioulnargelenks. Obere Extremität 10, 208–214 (2015). https://doi.org/10.1007/s11678-015-0342-0

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  • DOI: https://doi.org/10.1007/s11678-015-0342-0

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