Modified Sauveé Kapandji operation for treatment of chronic post-traumatic derangement of the distal radioulnar joint | ||
| The Egyptian Orthopaedic Journal | ||
| Volume 47, Issue 4, December 2012, Pages 431-436 PDF (216.43 K) | ||
| Author | ||
| Mohamed Osman Mohamed | ||
| Abstract | ||
| Background Once the distal radioulnar joint (DRUJ) has been damaged, it is unlikely that normal anatomy and function can be restored. The Sauvé -Kapandji operation is a popular choice among the several surgical salvage operations available. Patients and methods Eighteen patients with chronic post-traumatic derangement of DRUJ were treated by a modified Sauvé -Kapandji operation (with extensor carpi ulnaris tenodesis). The mean age of patients was 30 years (range, 22-45 years). All patients presented with pain in DRUJ, impaired forearm rotation, and weakness of grip strength. Results Two patients were lost to follow-up and were excluded from the study. On using the modified Mayo wrist scoring system (at a mean of 16 months of follow-up), 12 patients had satisfactory outcome and four patients presented a fair outcome (but not poor). The severity of pain improved in all patients (no pain in nine, mild pain in six, and moderate pain in one). The forearm rotation improved in all patients. The mean grip strength improved from 35 to 81% of that of the unaffected side. Thirteen patients (81.3%) returned to their previous work and activity levels, whereas three patients (18.7%) returned to lighter work. Complications included ulnar stump instability in one patient (treated by flexor carpi ulnaris tenodesis), neuroma of dorsal sensory branch of the ulnar nerve (one patient), and gap ossification in three patients (it required excision only in one patient). Conclusion The Sauvé -Kapandji operation is a satisfactory salvage procedure for the treatment of chronic post-traumatic derangement in young active patients, as it can reliably restore rotation of the forearm and grip strength while relieving pain and maintaining a functional range of motion of the wrist. However, problems with pain and instability of the ulnar stump are not infrequent. Tenodesis of the extensor carpi ulnaris provides static stabilization by tethering the ulnar stump to the carpus. Keywords: arthrosis, chronic derangement, distal radioulnar joint, instability, Sauve -Kapandji operation | ||
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