Long-term efficacy of modified Sauvé-Kapandji procedure for treatment of degenerative arthritis of distal radioulnar joint

Abstract

Objective To investigate the long-term clinical efficacy of modified Sauve-Kapandji procedure in the treatment of degenerative arthritis of distal radioulnar joint (DRUJ). Methods From June 2010 to April 2015, 16 patients with DRUJ degenerative arthritis were treated with modified Sauve-Kapandji procedure. The ulna of 1.0 to 1.5 cm length was excised at 2 to 3 cm proximal to the ulna head. The distal ulna and DRUJ were fused with the radius. The proximal ulna was suspended with a splited 1/2 extensor carpi ulnaris tendon. After operation, the long arm plaster was fixed for 3 to 4 weeks, then functional exercise was performed, and normal work was restored after bone healing. Results After the operation all the patients were follow-up for 3.3 to 7.0 years with an average of 4.2 years. Postoperative pain relieved, grip strength increased, forearm rotation had no significant effect, and no instability of ulna stump occurred. The pain was improved from 6.2 to 1.5 points by using the visual analogue scales (VAS). The grip strength of both hands was measured by Jamar gripper, and the percentage of grip strength of the affected hand to the healthy side recovered from an average of 30% to 85% after the operation. The total wrist function was assessed by Mayo score from 56 preoperatively to 87 postoperatively, and DASH score from 67 preoperatively to 28 postoperatively. Conclusion The application of modified Sauve-Kapandji procedure for treatment of DRUJ degenerative arthritis can stabilize ulnar stump, prevent wrist instability, relieve wrist-ulnar pain and improve forearm rotation. The clinical effect is satisfactory after operation. Key words: Osteoarthritis; Treatment outcome; Distal radioulnar joint; Sauve-Kapandji procedure