Radiographic parameter analysis on modified sauvé-kapandji procedure

Area of Science:

• Orthopedic Surgery
• Rheumatology
• Radiology

Background:

• The Sauvé-Kapandji (S-K) procedure is a standard treatment for distal radioulnar joint (DRUJ) dysfunction.
• Patients with poor bone quality, often due to rheumatoid arthritis (RA), face challenges with the conventional S-K procedure, risking reduced wrist width and grip strength.

Purpose of the Study:

• To evaluate the radiographic outcomes of a modified S-K procedure.
• This modification involves rotating the resected ulnar segment to bridge the gap between the sigmoid notch and ulnar head.

Main Methods:

• The modified S-K procedure was performed on 29 wrists in 23 patients (21 with severe RA, 2 with radius fractures).
• Radiographic assessments included radioulnar width, pseudarthrosis gap, radioulnar distance, and carpal ulnar translation.
• Mean follow-up was 43 months.

Main Results:

• The modified technique successfully maintained wrist radioulnar width, pseudarthrosis gap, and radioulnar distance.
• A decrease in radioulnar width post-surgery correlated with increased carpal ulnar translation.

Conclusions:

• Maintaining radioulnar width is vital to prevent progressive carpal ulnar translocation.
• The modified S-K procedure effectively preserves distal ulna position and carpal support, benefiting patients with severe RA and poor bone quality.