Management of idiopathic Madelung deformity with the Sauve-Kapandji procedure

Abstract

Background: Madelung deformity is a growth disorder affecting the distal radial epiphysis presenting usually near skeletal maturity with wrist pain, deformity, and limitation of wrist motion. Methods: Ten patients (13 wrists) with idiopathic Madelung deformity were treated with the Sauve-Kapandji procedure. The mean age at the time of operation was 21.8 yr old. The mean follow-up was 16.2 mo. Results: The ulnar head united successfully to the distal radius in all patients. The mean time of union was 10.3 wk. At the final follow up, all wrists were painless. The mean VAS of pain during stressful conditions improved from 6.2 to 2.3. The grip strength improved from 6.7 to 13.2. The mean DASH score improved from 41.9 to 13.2. Conclusions: The Sauve-Kapandji procedure is relatively simple procedure compared to radial osteotomy. It decreases pain and improves strength of wrists with Madelung deformity.

Madelung Deformity: Radioscapholunate Arthrodesis With a Neo-DRUJ

“…21 Pain was mainly localized to the areas between the distal radius and ulna, and the ulnar side of the wrist. One recent case series study, describing outcomes after a Sauvé-Kapandji procedure, 22 reported mean VAS scores of 2.3 (SD = 0.6) 23 with a mean follow-up of 16 months. Other studies described only the presence or absence of pain without any quantification.…”

“…The use of PROMs in Madelung deformity research has been limited. The few studies that implement PROMs either use the Disabilities of the Arm, Shoulder and Hand (DASH), 29 QuickDASH, 30 or Patient-Rated Wrist/Hand Evaluation 11,19,23,27 ; overall, patients reported being satisfied with both functional outcomes and esthetics. For future studies, we would recommend using the Patient Reported Outcomes Measurement Information System, as it has been shown to have high validity and reliability in congenital hand research.…”