[Resection of the head of the ulna in patients with rheumatoid arthritis].
OBJECTIVE
The purpose of the study was to investigate value and effect of distal ulna resection (Darrach procedure) on the wrist in rheumatoid arthritis.


METHODS
From 1985 to 1995, resection of the distal ulna was performed in 47 patients (54 hands) with rheumatoid arthritis. 38 patients (6 men, 32 women, 43 hands) had an average clinical and radiological follow up of 4.7 years (range 3 to 13 years).


RESULTS
15 of the cases with rheumatoid arthritis were pain-free, 19 complained about pain after severe stress, seven complained about pain after mild stress and two about continuous pain. 85% of the patients had a range of motion (pro- and supination) of more than 120 degrees. 75% of the patients had a good or very good wrist function. In 32 cases, the patients were absolutely satisfied with the operative outcome, in five cases, they had expected more improvement. Six reported, that there was no change due to the operation.


CONCLUSIONS
The results demonstrate that the main indication for the resection of the distal ulna is rheumatoid arthritis. This operation does not influence the progress of rheumatoid arthritis. Preoperative radiological changes (Larsen's classification) have the main prognostic value. In Larsen's II and higher, a partial arthrodesis is recommended.
Vispo Seara
J L
JL
Orthopädische Universitätsklinik, König-Ludwig-Haus, Würzburg.
Walther
M
M
Gohlke
F
F
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000601:surgery*; D001174:Arthrodesis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D014457:Ulna / Q000000981:diagnostic imaging / Q000601:surgery*; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery*