The Kapandji procedure for post-traumatic problems

The Kapandji procedure was performed on 14 patients who presented with chronic pain at the distal radioulnar joint, limited forearm rotation or poor grip after an injury involving the distal radioulnar joint. Ten patients were able to resume their original occupation and leisure activities. Some complained of mild aching after heavy use. Postoperatively, grip strength on the affected side was, on average, 84 per cent that of the opposite side. Forearm rotation in the affected arm averaged 129 degrees before operation and 170 degrees afterwards, compared with 171 degrees on the normal side, while wrist flexion-extension averaged 129 degrees preoperatively, 126 degrees postoperatively and 148 degrees on the normal side. Four patients had less satisfactory results because of pain and a feeling of insecurity due to an unstable proximal ulna. However, two of these had severe residual problems in relation to the initial forearm component of the injury, the symptoms from which were difficult to separate from the distal radioulnar injury. Although the Kapandji procedure can yield excellent results, it is difficult to predict which patients will suffer from an unstable ulna.