Sauve-Kapandji Remains a Viable Option for Distal Radioulnar Joint Dysfunction

Abstract

Introduction Dysfunction of the distal radioulnar joint (DRUJ) can be significantly debilitating. The Sauve-Kapandji (S-K) procedure can be indicated to address multiple etiologies of DRUJ dysfunction. The purpose of this study was to review our institution’s results performing the S-K procedure for DRUJ dysfunction in terms of clinical and radiographic outcomes, as well as complications and reoperations. Methods A retrospective review of S-K procedures performed at 2 institutions between 1998 and 2017 with a minimum of 1-year follow-up was performed. Preoperative and postoperative visual analog scale (VAS) pain, grip strength, and wrist range of motion were reviewed. Radiographs were reviewed for DRUJ healing, carpal translation, and radiocarpal degenerative changes. Results The cohort included 35 patients. The mean age was 51 years. The mean follow-up was 49.5 months. The postoperative range of motion was unchanged in regard to pronation, supination, and wrist extension. There was a decrease in wrist flexion from 43 degrees to 34 degrees. Successful union was noted in 100% of the wrists. There was 1 case (2.8%) of progressive ulnar translation and 4 major complications (11.3%). Conclusion The S-K procedure has several theoretical benefits compared to other procedures for DRUJ dysfunction with results of this study demonstrating excellent pain relief, improved postoperative grip strength, retained wrist pronation, supination, and extension, high rate of successful arthrodesis and low rate of major complications. Level of Evidence Level IV

The outcome of Sauve Kapandji procedure on patient with DRUJ arthritis: A case report

“…In general, the SK technique continues to be a feasible therapy option for DRUJ dysfunction. This study reveals outstanding pain alleviation, enhanced postoperative grip strength, retained wrist pronation, supination, and extension, a high rate of successful arthrodesis, and a low incidence of significant sequelae [1] .…”

“…The distal radioulnar joint (DRUJ) is frequently involved in inflammatory diseases, both degenerative and notably traumatic, resulting in pain, wrist motion and strength loss, and severe functional impairment [1] , [2] . DRUJ dysfunction can be highly incapacitating.…”

“…DRUJ dysfunction can be highly incapacitating. Multiple causes of DRUJ dysfunction, such as rheumatoid arthritis, osteoarthritis, post-traumatic arthritis, and congenital abnormalities, can be treated with the Sauve-Kapandji (SK) procedure [1] . There are numerous surgical treatment options, none of which have been demonstrated to be superior in the medical literature [1] , [3] .…”

Sauvé-Kapandji and Darrach Salvage Procedure Rates and Perioperative Parameters for Distal Radioulnar Joint Arthritis and Instability

“…This is likely due to physician and patient preference for the S-K procedure because it is regarded as the preferred procedure for active patients or those whose occupation is physical in nature due to its preservation of force transmission and improvement in grip strength. 5,9-11,17-20 Predictably, patients aged <35 years also undergo the S-K procedure at higher rates than the Darrach group. It is worthwhile to note that patient demographics, such as income, insurance status, and hospital setting, had no effect on Darrach and S-K procedure rates.…”