[Kapandji corrective operation of post-traumatic disorder of the distal radio-ulnar joint]

The Sauvé-Kapandji procedure comprises distal radioulnar arthrodesis with screwing of the caput ulnae at the basis of the radius after the correction of the radioulnar length discrepancy. Therefore the best indications are posttraumatic changes of the distal radioulnar joint. At the same time a distal ulnar segment resection about 12 mm in length is necessary to restore forearm rotation, producing an iatrogenic pseudarthrosis. The proximal ulnar segment functionally assimilates to a rotating joint, as could be shown by X-rays. Between 1988 and 1993 this procedure was performed in 12 patients. Follow-up after an average of 38.2 months showed improvements in forearm rotation of 84% for pronation and 60% for supination. All patients had significant pain relief. Grip strength also improved, by 55%. No patient got worse postoperatively as measured by the score of Gartland and Werley. Neither non-union of the distal radioulnar joint fusion nor bony regeneration across the resected ulnar segment was seen. The good results are the consequence of adherence to a rigorous indication: no preexisting arthrosis at the radiocarpal joint.