The Sauve-Kapandji Procedure: Its Indications and Tech-Niques

The Sauve-Kapandji procedure has gained popularity in the treatment for distal radio-ulnar joint incongruity and yielded more satisfactory outcomes than the Darrach procedure. However, there is controversy regarding indications and techniques. The personal experience of the senior author with a total of 42 wrists was evaluated retrospectively (26 rheumatoid arthritis; 16 traumatic injury). Briefly, the distal ulna was resected by subperiosteal dissection. The periosteum was completely separated from the surrounding tissue, closed over the ulnar stump, and sutured to the extensor carpi ulnaris tendon sheath. Postoperatively, all patients were satisfied with both pain relief and functional improvement. There were no major surgical complications. Four wrists of the posttraumatic group developed ossification at the pseudoarthrosis gap, but only mild restriction of motion was noted postoperatively. No wrists affected by rheumatoid arthritis showed ossification. Some cases with ossification have been reported in the literature, with one showing complete fusion at the pseudoarthrosis site. The authors' opinion is that the essential surgical indication is the presence of destruction or deformity of the distal radio-ulnar articular surfaces. The Sauve-Kapandji procedure is recommended for younger, relatively active patients; it is also recommended for patients with concomitant ulnar translation of the carpus or ulnar-sided defect of the distal radius, even low-demand patients such as those with rheumatoid arthritis. The Sauve-Kapandji procedure does not replace the Darrach procedure as an all-purpose approach for distal radio-ulnar joint disorders and should not be extensively used, especially in patients with posttraumatic conditions.

並列關鍵字

distal radio-ulnar joint ； arthrodesis ； ulnar head resection ； arthroplasty ； pseudoarthrosis

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