手根背屈変形（ＤＩＳＩ）の整復経験

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  • Reduction of DISI deformity of the wrist.

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Reduction of DISI deformity was carried out in 3 cases of scapholunate dissociation, 3 cases of reduced perilunate dislocation with persistent carpal deformity, and 15 cases of chronic scaphoid fracture. The chronic scaphoid fractures were treated by Kirshner wire reduction, bone graft and internal fixation with a Herbert screw. Various methods of reduction including Fisk's method and Cooney's method were employed in reducing the DISI deformity in the cases of scapholunate dissociation and perilunate dislocation.<BR>Satisfactory reduction could be obtained in 14 cases of scaphoid fracture. In the cases with scapholunate dissociation and perilunate dislocation, reduction gave some degree of improvement of the DISI deformity, but in none of the cases was normal carpal alignment achieved, despite the use of multiple procedures for maintaining reduction, such as repair of the volar carpal ligament and temporary fixation between carpal bones with Kirschner wires. The results show that DISI deformity with a ligamentous origin is difficult to reduce and that additional procedures are necessary to maintain the reduction which was supposed to be accomplished by traction provided by an external fixator.

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