The Sauvé-Kapandji procedure: A salvage operation for the distal radioulnar joint

Sanders, Richard A.; Frederick, Hugh A.; Hontas, Roch

doi:10.1016/s0363-5023(10)80078-4

Cited by 84 publications

(45 citation statements)

References 10 publications

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“…Sauve and Kapandji described distal radioulnar arthrodesis with creation of a surgical pseudoarthrosis of the distal ulna for treatment of DRUJ derangement in 1936 (Sanders et al, 1991;Sauve and Kapandji, 1936). The Sauve-Kapandji procedure has been used effectively to treat post-traumatic DRUJ derangement in older, sedentary patients as well as younger, highdemand patients.…”

Section: Introductionmentioning

confidence: 99%

The Sauve–Kapandji Procedure and the Darrach Procedure for Distal Radio–Ulnar Joint Dysfunction after Colles’ Fracture

George

Kiefhaber

Stern

2004

Journal of Hand Surgery

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This retrospective study evaluated the results of the Darrach procedure and the Sauve-Kapandji procedure for the treatment of distal radio-ulnar joint derangement following malunion of dorsally displaced, unstable, intraarticular fractures of the distal radius in patients under 50 years of age. Twelve of 18 possible patients in the Sauve-Kapandji group completed the disabilities of the arm, shoulder, and hand survey at a mean of 4 years postoperatively and nine of the 18 returned for a follow-up examination at a mean of 2 years. Twenty-one of 30 possible patients in the Darrach group completed the disabilities of the arm, shoulder, and hand survey at a mean of 6 years postoperatively and 13 of these 30 returned for follow-up examination at a mean of 4 years. The Darrach procedure and the Sauve-Kapandji procedure yielded comparable and unpredictable results with respect to both subjective and objective parameters.

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Section: Introductionmentioning

confidence: 99%

The Sauve–Kapandji Procedure and the Darrach Procedure for Distal Radio–Ulnar Joint Dysfunction after Colles’ Fracture

George

Kiefhaber

Stern

2004

Journal of Hand Surgery

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“…In contrast to the Darrach procedure, the advantage of the Sauvé-Kapandji procedure is that the ulnar head (i.e. third column) with it amount of 34% of total for complete load transmission through the wrist is preserved as well as the stability of the wrist is not altered by preservation of the RULs and ulnocarpal ligaments, and so it has been advocated for patients with high-demand claims in their activities of daily living who sustained posttraumatic disorders [119][120][121][122][123][124]. Additionally, this procedure can also be an option for primary shortening of the forearm in elderly patients with severely comminuted distal radius fractures in order to avoid posttraumatic UPV [125,126].…”

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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“…The S-K procedure is frequently used to treat DRUJ disorders in RA patients, and good clinical outcomes have been widely reported in the literature [6,[8][9][10][11][16][17][18][19]. However, there have been few reports of the outcome of the modified S-K procedure [12].…”

Section: Discussionmentioning

confidence: 99%

The short-term outcome of the modified Sauvé–Kapandji procedure regarding range of motion, carpal bone translation and bony shelf size

Toyama¹,

Tamai²,

Sakamoto³

et al. 2010

Mod Rheumatol

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The Sauvé-Kapandji (S-K) procedure is a common treatment for rheumatoid wrists, but in some cases severe bone destruction makes this operative modality difficult to perform, while also resulting in a poor outcome. A modified S-K procedure for these wrists has been reported, but the clinical outcomes of the modified procedure are unclear. This study evaluated 24 wrists in 20 patients who underwent the modified S-K procedure. The mean follow-up period was 34.5 months. The clinical assessments were range of motion, carpal bone translation and bony shelf size. The range of motion and carpal bone translation were similar to those produced by the S-K procedure. In regard to bony shelf size, wrists with an excessively large bony shelf tended to have a progression of carpal bone translation toward the palmar direction due to the residual malposition of the ECU tendon. The modified S-K procedure appears to be a safe and effective surgical alternative for the treatment of severely destroyed rheumatoid wrists. Although the modified procedure allows for the adjustment of the bony shelf size, it should not be used with wrists that have an excessively large bony shelf.

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The Sauvé-Kapandji procedure: A salvage operation for the distal radioulnar joint

Cited by 84 publications

References 10 publications

The Sauve–Kapandji Procedure and the Darrach Procedure for Distal Radio–Ulnar Joint Dysfunction after Colles’ Fracture

The Sauve–Kapandji Procedure and the Darrach Procedure for Distal Radio–Ulnar Joint Dysfunction after Colles’ Fracture

The short-term outcome of the modified Sauvé–Kapandji procedure regarding range of motion, carpal bone translation and bony shelf size

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