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

Abstract

These findings suggest that proximal ulnar stump pain may be caused not by radial or dorsal deviation of the proximal ulnar stump but by other dynamic factors.

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

“…12 Tomori et al, 2018 also reported a significant improvement of pain post operatively in patients undergoing various modifications of Sauvé-Kapandji procedure. 10 In our study, we observed a 89.88 percentage improvement in VAS scores for wrist pain with a statistical significance of p<0.001 at 2 year follow up.…”

“…The extensor carpi ulnaris tendon is usually used to suspend and stabilize the ulna shaft in the modified procedure. [8][9][10] Retaining the ulnar head may allow for more normal transmission of force through the wrist, which may make this the preferred procedure in patients with "highdemand" wrists. While the DRUJ is fused, forearm pronation and supination are maintained or even improved by pseudoarthrosis of the ulna.…”

Ossification of the pseudarthrosis following the Sauvé-Kapandji procedure: a case report and review of the literature

“…A variety of surgical modifications of the SK procedure have been labeled to ameliorate the complication of ulnar stump pain- and hypermobility [ 10 ]. However, while ossification of the pseudarthrosis produces a similar debilitating complication rate amounting in surgical revision, above mentioned surgical modifications do not seem to affect the occurrence rate ( Table 1 ).…”

“…[ 11 ] suggest keeping the gap narrow to prevent proximal ulnar stump hypermobility. Contrarily, several authors argue that a gap of up to 15 mm produces most favorable results [ 8 , 10 , 12 , 13 ] (see Table 1 ), and Zachee et al. [ 14 ] state that early postoperative mobilization of the wrist could prevent re-ossification of the gap.…”

“…In our case, radiologic evidence of ossification was noted 17 months after surgery and progressed precipitously to near complete synostosis within 18 months postoperatively with concomitant loss of pronation and supination. With the distal radioulnar arthrodesis-hardware out of reach of the proximal ulnar stump, the remaining potentially stimulating and modifiable factors at the osteotomy site is limited to soft tissue interposition-, stabilization, or suspension methods previously described by several authors ( Table 1 ) [ 5 , 9 , 10 , 15 , 17 ]. However, according to this literature review, no significant pattern can be elucidated when evaluating for a trend of ossification towards one specific procedure modification.…”