Amount of ulnar resection is a predictive factor for ulnar instability problems after the Sauvé-Kapandji procedure: A retrospective study of 44 patients followed for 1–13 years

Daecke, W.; Martini, Abdul Kader; Schneider, Sven; Streich, N.

doi:10.1080/17453670610046055

Cited by 22 publications

(10 citation statements)

References 21 publications

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“…Excessive resection of the distal ulna usually results in painful instability of the stump or a click [17–20]. In the present case, the distal stump of the ulna after resection of the distal ulna including GCT lesion was stabilized by the method previously reported in our papers [5, 6].…”

Section: Discussionmentioning

confidence: 54%

Giant-Cell Tumor of the Distal Ulna Treated by Wide Resection and Ulnar Support Reconstruction: A Case Report

Minami

Iwasaki

Nishida

et al. 2010

Case Reports in Medicine

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Giant-cell tumor of bone occurred in the distal end of the ulna is extremely uncommon. A 23-year-old male had a giant-cell tumor occurred in the distal end of the ulna. After wide resection of the distal segment of the ulna including giant-cell tumor, ulnar components of the wrist joint were reconstructed with modified Sauvé-Kapandji procedure using the iliac bone graft, preserving the triangular fibrocartilage complex and ulnar collateral ligament in order to maintain ulnar support of the wrist, and the proximal stump of the resected ulna was stabilized by tenodesis using the extensor carpi ulnaris tendon. One year after operation, the patient's wrist was pain-free and had a full range of motion. Postoperative X-rays showed no abnormal findings including recurrence of the giant-cell tumor and ulnar translation of the entire carpus. The stability of the proximal stump of the distal ulna was also maintained.

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Section: Discussionmentioning

confidence: 54%

Giant-Cell Tumor of the Distal Ulna Treated by Wide Resection and Ulnar Support Reconstruction: A Case Report

Minami

Iwasaki

Nishida

et al. 2010

Case Reports in Medicine

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“…dynamic divergence instability). To avoid radioulnar instability, it is recommended that the shortening of the ulna stump should not exceed 35 mm proximal to the DRUJ [136]. When postoperative dynamic radioulnar instability occurs, then an individually customized thermoplastic functional forearm brace, formerly introduced by Sarmiento et al for the non-operative treatment of forearm fractures, is able to reduce postoperative discomfort such as in our presented patient's case [137,138].…”

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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“…Kapandji (1986) recommended a short fragment of the distal ulna and a small ulnar gap to reduce instability of the ulna. Daecke et al (2006) examined the relationship between position of ulnar resection and instability of ulnar stump, suggesting a correlation between instability and the position of ulnar resection. They reported that shortening of the proximal stump to 35 mm or less improved motion and led to high patient satisfaction, while bony bridging can be prevented by a pseudarthrosis gap of approximately 10 mm.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of the modified Sauvé–Kapandji procedure for rheumatoid wrist with and without stabilization of the proximal ulnar stump

Kawabata

Egi

Hashimoto

et al. 2010

J Hand Surg Eur Vol

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We compared the clinical and radiological results of the modified Sauvé-Kapandji procedure for 41 of 86 operated rheumatoid wrists with (n=22) and without (n=19) stabilization of the proximal ulnar stump with a slip of half the extensor carpi ulnaris tendon. Gender, age, and follow-up period were similar in the two groups. We found no difference clinically or on radiographs between the two groups other than better early postoperative pain relief in those stabilized. Stabilization of the proximal ulnar stump may not be necessary in the modified Sauvé-Kapandji procedure for rheumatoid wrists.

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Amount of ulnar resection is a predictive factor for ulnar instability problems after the Sauvé-Kapandji procedure: A retrospective study of 44 patients followed for 1–13 years

Cited by 22 publications

References 21 publications

Giant-Cell Tumor of the Distal Ulna Treated by Wide Resection and Ulnar Support Reconstruction: A Case Report

Giant-Cell Tumor of the Distal Ulna Treated by Wide Resection and Ulnar Support Reconstruction: A Case Report

A comparative study of the modified Sauvé–Kapandji procedure for rheumatoid wrist with and without stabilization of the proximal ulnar stump

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