Long-term results of Sauvé-Kapandji procedure

The Sauvé-Kapandji procedure is an established treatment option for distal radioulnar joint dysfunction. We retrospectively analysed 36 patients following Sauvé-Kapandji procedure between 1997 and 2013. Fifteen patients were available for a follow-up after a mean of 13 years (range 6 to 23). Six patients needed revision surgery because of ulnar stump instability. Radiographs and sonography were performed to quantify the instability of the proximal ulnar stump. These showed a radioulnar convergence of 8 mm without weight and 2 mm while lifting 1 kg. Sonographically, the proximal ulnar stump dislocated by 8 mm to the volar side while applying pressure to the palm, compared with 4 mm on the contralateral side. Sonographically measured ulnar stump instability showed a positive strong correlation with the Disabilities of the Arm, Shoulder and Hand questionnaire and Patient-Reported Wrist Evaluations and a negative strong correlation with grip strength and supination torque. Because of the high incidence of revision surgery due to instability of the proximal ulnar stump, we restrict the use of the Sauvé-Kapandji procedure only to very selected cases.Level of evidence: IV.