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

Abstract

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.

Stabilization of the Proximal Ulnar Stump in the Sauvé-Kapandji Procedure by Using the Extensor Carpi Ulnaris Tendon: Long-Term Follow-Up Studies

“…[1][2][3][4][5][6][7]10,11 Smet and Ransbeeck reported the outcome of the S-K procedure for posttraumatic wrist disorders. Eighty-four patients were treated, all with posttraumatic disorders of the DRUJ.…”

“…[1][2][3] Satisfactory clinical results have been obtained in most reports, however, instability of the proximal ulnar stump and radioulnar convergence have caused problems similar to those seen after Darrach's procedure at average follow-up periods ranging from 29 to 96 months in several papers. [3][4][5][6] Instability of the proximal ulna allows convergence of the ulna and radius. Narrowing of the interosseous space allows impingement of the proximal ulnar stump on the distal radial metaphysis.…”

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

“…According to Sanders et al (1991), the clinical sign of ulnar instability is "complaint of pain at the pseudarthrosis site while lifting with the forearm in supination". Other definitions are "pain over the proximal ulnar stump", "painful click or painless click", or variations of these , Carter and Stuart 2000, Minami et al 2000, Sawaizumi et al 2001, George et al 2004. Clinical evaluation of ulnar instability is even more problematic than defining it.…”

Reconstruction of the Distal Ulna: Instability, Impaction, Impingement, and Arthrosis

“…Both of these procedures should be considered salvage operations, and the clinical series that describe results related to their use advocate their use for the nonreconstructable joint. [27][28][29] The HIT is indicated for derangement of the DRUJ in the setting of an intact or reconstructable TFC. 28,30 The HIT reduces clinical symptoms related to an arthritic DRUJ but does not restore normal joint kinematics.…”