Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Hand/Wrist
Abstract number: 26451
TOTAL DRUJ- ARTHROPLASTY AS SALVAGE FOR SALVAGE PROCEDURES,
4- YEAR REPORT
Peter AXELSSON
Sahlgrenska University Hospital, Gothenburg (SWEDEN)
INTRODUCTION: There are few treatment alternatives for severe DRUJ problems.
When primary repair fails surgeons are often forced to choose between unpredictable
methods like Partial or complete caput ulna resection as well as Sauve-Kampandji
arthrodesis. Subsequently it is not uncommon that the patient and the surgeon find
themselves in an even worse situation with both damaged joint surfaces and
instability. In the last decade several new implants has entered the market, among
them the Aptis (Scheker) DRUJ prosthesis which is a constrained type of total joint
arthroplasty. PATIENTS AND METHODS: During spring 2006 the author operated
four patients with the Aptis prosthesis. Complaints and indication were as follows;
Painfull instability; after complete caput ulna resection; in a Sauve-Kampandji wrist;
in wrist and elbow following Essex-Lopresti injury Aching and total lack of forearm
rotation due to DRUJ synostosis following forearm fracture (patient 4) RESULTS:
Due to the complete difference in patient characteristics there are few statistical
conclusions to be made from the clinical outcome. However some results are worth
mentioning. X-rays shows no signs of loosening in any patient Mean values
decrease, DASH 33% (22 points), VAS-pain 85%Mean values, increase in grip
strength, (Jamar) 33%, lift-strength 47%, torque-supination 166%, torque-pronation
96%Patient 4 went from 0-150 degrees in forearm rotation while there was no
relative change in the other patients DISCUSSION Follow up indicates that The Aptis
DRUJ arthroplasty is a safe and effective solution in the severely damaged DRUJ
joint.
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