DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20210623

Functional outcomes after modified Sauve-Kapandji arthrodesis for distal radioulnar joint dysfunction

Hiranya Kumar Seenappa, Karthik Narayanamurthy Mittemari, Shivaraj Nadagouda, Vamshikrishna Chand Nimmagadda

Abstract


Background: The distal radioulnar joint (DRUJ) dysfunction manifests as pain, weakness and reduced range of motion. There are various treatments for DRUJ dysfunction. Modified Sauvé-Kapandji procedure involves arthrodesis of the distal radioulnar joint combined with the creation of a pseudarthrosis of the distal ulna to maintain forearm pronation and supination, and stabilization of proximal ulnar stump. This study was performed to evaluate the clinical outcomes of modified Sauve-Kapandji procedure for patients with DRUJ dysfunction.

Methods: Fourteen patients with DRUJ dysfunction were treated by modified Sauve-Kapandji procedure and followed up for 2 years post-operatively. Functional assessment was evaluated according to modified mayo wrist score (MMWS) system and severity of pain by visual analog scale. Posteroanterior and lateral radiographs were used to assess fusion.

Results: There was a significant improvement in VAS of wrist pain (p<0.001) and MMWS (p<0.001) at 2 years follow up. Excellent outcome was reported in 64.3% (n=9) patients. Radiographic fusion was seen in all 14 cases.

Conclusions: The modified Sauve-Kapandji procedure for DRUJ dysfunction is a safe and effective procedure with excellent radiological fusion and significant improvement in functional outcomes.

 


Keywords


Distal radioulnar joint, Modified Sauvé-Kapandji procedure, Modified mayo wrist score

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References


Houdek MT, Wagner ER, Moran SL, Berger RA. Disorders of the distal radioulnar joint. Plast Reconstr Surg. 2015;135:161-72.

Lichtman DM, Ganocy TK, Kim DC. The indications for and techniques and outcomes of ablative procedures of the distal ulna. The Darrach resection, hemiresection, matched resection, and Sauve-Kapandji procedure. Hand Clin. 1998;14(2):265-77.

Darrach W. Partial excision of lower shaft of the ulna for deformity following Colles’s fracture. Clin Orthop Relat Res. 1992(275):3-4.

Sauvé L, Kapandji M. Nouvelle technique de traitement chirurgical des luxations récidivantes isolées de l'extrémité inférieure du cubitus. J Chir (Paris). 1936;47:589-94.

Guo Z, Wang Y, Zhang Y. Modified Sauve-Kapandji Procedure for Patients with Old Fractures of the Distal Radius. Open Med (Wars). 2017;12:417-23.

Minami A, Kato H, Iwasaki N. Modification of the Sauve-Kapandji procedure with extensor carpi ulnaris tenodesis. J Hand Surg Am. 2000;25:1080-4.

Fujita S, Masada K, Takeuchi E, Yasuda M, Komatsubara Y, Hashimoto H. Modified Sauve-Kapandji procedure for disorders of the distal radioulnar joint in patients with rheumatoid arthritis. Surgical technique J Bone Joint Surg Am. 2006;88(l):24-8.

Lluch A. The Sauvé-Kapandji procedure. J Wrist Surg. 2013;2(1):33-40.

Vincent KA, Szabo RM, Agee JM. The Sauve-Kapandji procedure for reconstruction of the rheumatoid distal radioulnar joint. J Hand Surg Am. 1993;18(6):978-83.

Tomori Y, Sawaizumi T, Nanno M, Takai S. Functional outcomes after the Sauvé-Kapandji procedure for distal radio-ulnar post-traumatic instability: a case-control comparison of three different operative methods of stabilization of the ulnar stump. Int Orthop. 2018;42(9):2173-9.

Rothwell AG, O'Neill L, Cragg K. Sauvé-Kapandji procedure for disorders of the distal radioulnar joint: a simplified technique. J Hand Surg. 1996;21:771-7.

Minami A, Iwasaki N, Ishikawa J, Suenaga N, Yasuda K, Kato H. Treatments of osteoarthritis of the distal radioulnar joint: long-term results of three procedures. Hand Surg. 2005;10:243-8.

Carl HM, Lifchez SD. Functional and Radiographic Outcomes of the Sauvé-Kapandji and Darrach Procedures in Rheumatoid Arthritis. J Hand Microsurg. 2019;11(2):71-9.

Giberson-Chen CC, Leland HA, Benavent KA, Harper CM, Earp BE, Rozental TD. Functional Outcomes After Sauve-Kapandji Arthrodesis. J Hand Surg Am. 2020;45(5):408-16.

Yayac M, Padua FG, Banner L, Seigerman DA, Beredjiklian PK, Aita DJ et al. Treatment Outcomes in Patients Undergoing Surgical Treatment for Arthritis of the Distal Radioulnar Joint. J Wrist Surg. 2020;9(3):230-4.