Distal radioulnar joint arthroplasty: The hemiresection-interposition technique

Bowers, William H.

doi:10.1016/s0363-5023(85)80100-3

Cited by 388 publications

(164 citation statements)

References 7 publications

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“…Fourthly, preservation of the ulnar head results in a normal wrist contour. The disadvantage of the SauvC-Kapandji technique is that the proximal ulna may give rise to pain and instability (Bowers 1985, Taleisnik 1992). In our study, 2 patients had discomfort at the ulnar site after heavy work, but not at rest or with normal daily activity.…”

Section: Discussionmentioning

confidence: 99%

Sauve-Kapandji operation for disorders of the distal radioulnar joint after Colles' fracture: Good results in 12 patients followed for 1.5-4 years

Mikkelsen¹,

Lindblad²,

Larsen³

et al. 1997

Acta Orthopaedica Scandinavica

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Section: Discussionmentioning

confidence: 99%

Sauve-Kapandji operation for disorders of the distal radioulnar joint after Colles' fracture: Good results in 12 patients followed for 1.5-4 years

Mikkelsen¹,

Lindblad²,

Larsen³

et al. 1997

Acta Orthopaedica Scandinavica

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“…DRUJ arthritis and other pathology have been managed conventionally with deletive procedures such as total ulnar head resection, 3 partial ulnar head resection, 4 with or without interposition, 5 and DRUJ arthrodesis. 6,7 Complications after distal ulna resections are not uncommon.…”

mentioning

confidence: 99%

Indications and early to mid-term results of ulnar head replacement

Warwick¹,

Shyamalan

Balabanidou

2013

annals

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INTRODUCTION The aim of this study was to explore the indications and show the early to mid-term results of ulnar head replacement for the treatment of pathological conditions of the distal radioulnar joint. METHODS Our study group comprised 52 patients with a mean age of 64 years who had 56 ulnar head replacements. Seven were implanted to salvage an unstable deletive procedure; the rest were for primary treatment of osteoarthritis, rheumatoid arthritis and trauma. Concomitant procedures along with the ulnar head replacement included wrist arthrodesis, joint replacement and tendon transfers. RESULTS The follow-up duration ranged from 1 year to 11 years (mean: 60 months, median: 60 months). In almost all of the patients, pain improved with a median visual analogue scale score of 2 (mean: 2.2, range: 0-8) and a median DASH (Disabilities of the Arm, Shoulder and Hand) score of 12.5 (mean: 17.9, range: 0-56). Of the 52 patients, 47 reported they would have the same procedure again. CONCLUSIONS Ulnar head replacement appears to be a reliable and effective procedure solving several pathological problems of the distal radioulnar joint. We present a large patient group with a short to medium-term follow-up duration.

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“…Ulnar head hemiresection ( Figure 11C) was first described in 1985 by Bowers, and 1986 modified with modeling of the ulnar stump by Watson et al [79,80]. However, both procedures are not free of any problems.…”

Section: Discussionmentioning

confidence: 99%

Who introduced the "quadrangular-construct" modification of the Sauvé Kapandji procedure first? Case presentation and brief overview of literature with regard to general, specific and practicable aspects to primary trauma-related surgical treatment including possible salvage options at the distal radioulnar joint

Schmidt¹,

Schmitz²,

Muradyan³

et al. 2017

Trauma Emerg Care

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A 26-year-old male sustained a left wrist injury after an occupational fall from height that was diagnosed as wrist sprain and treated conservatively by a plaster splint in another institution. Eight weeks after injury, the patient could be re-employed in his original occupation as a truck driver. Six years after injury, the patient came in our institution for the first time, and reported increasing pain in his left wrist accompanied with marked restriction of his left forearm's supination and pronation leading to the non-ability to carry out his occupational job 8 weeks previously. On clinical examination, there was pronounced dorsal subluxation of the ulnar head without any given possibilities for it manual closed reduction (i.e. static instability in transverse plane) ( Figure 1A). Posterior-anterior (PA) radiographs of both wrists showed no concomitant ulnar positiv variance (UPV) (i.e. no longitudinal instability) and no posttraumatic arthritic changes in the distal radioulnar joint (DRUJ), but the configuration of the ulnar styloid at the formerly injured left wrist could not be well assessed that suggested an additional rotation deformity of the ulnar head ( Figure 1B). Lateral radiographs of both wrist showed marked fixed subluxation of the ulnar head in dorsal direction (i.e. static instability in transverse plane) ( Figure 1C). Due to these findings, the Sauvé-Kapandji procedure, modified by creating a "quadrangularconstruct", was detected by us. At the preoperative radiographs of the left elbow in both planes there were no signs of any pre-existing degenerative changes with specific regard to the radiocapitellar joint.Intraoperatively, first, the 2 cm long ulna segment was excised typically proximal to the DRUJ, then a Kirschner-wire was drilled into the ulnar head parallel to the plane of the operation table on which the left forearm was positioned at terminal range of pronation (i.e. 90°) ( Figure 2A). After that, the ulnar head was rotated 90° perpendicular to the operation table's plane in dorsal direction using the formerly drilled Kirschner-wire, and so the neutral position of DRUJ could be achieved in which the arthrodesis had to be performed ( Figure 2B). Then, the cartilage of both corresponding surfaces in DRUJ was excised, and the DRUJ arthrodesis in neutral position was carried out using a 3.5 mm titanium malleolar screw, and the Kirschner-wire was removed. The next step included the several years later introduced "quadrangularconstruct" modification of the original Sauvé-Kapandji procedure: After decorticalization of the corresponding radius and ulna shafts proximal to the DRUJ arthrodesis and distal to resection plane of the ulna segment, the formerly excised ulna segment has been inserted transversely between both forearm bones and fixated with a second 3.5 mm titanium cortical screw through the ulna segment graft, and finally, complete restoration of rotation motion arc could be achieved ( Figures 2C-D). The correctly performed surgical procedure was confirmed intraoperatively by flu...

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Distal radioulnar joint arthroplasty: The hemiresection-interposition technique

Cited by 388 publications

References 7 publications

Sauve-Kapandji operation for disorders of the distal radioulnar joint after Colles' fracture: Good results in 12 patients followed for 1.5-4 years

Sauve-Kapandji operation for disorders of the distal radioulnar joint after Colles' fracture: Good results in 12 patients followed for 1.5-4 years

Indications and early to mid-term results of ulnar head replacement

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