Modification of the Sauvé-Kapandji procedure with extensor carpi ulnaris tenodesis

The Sauvé-Kapandji procedure is a useful treatment option for osteoarthritis of the distal radioulnar joint. Recent reports of a painful unstable proximal ulnar stump prompted us to develop a method of stabilizing the proximal stump of the ulna during the Sauvé-Kapandji procedure by using a half-slip of the extensor carpi ulnaris. Thirteen osteoarthritic wrists (8 primary and 5 traumatic) in 8 men and 5 women with an average age of 50 years were treated by this method. The length of the follow-up periods averaged 36 months. Pain improved in all patients after surgery but pain was elicited over 1 ulnar stump by direct pressure. Both pronation/supination and flexion/extension had statistically significant improvement with the exception of flexion. Grip strength improved in all wrists after surgery. Postoperative x-rays improved alignment in both coronal and lateral planes. Stabilization of the proximal ulnar stump associated with Sauvé-Kapandji procedure is a useful procedure to prevent an unstable ulnar stump in the treatment of osteoarthritis of the distal radioulnar joint.