Study of use of sauve- kapandji procedure in treating malunion of distal radius fractures

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Malunion is a common delayed complication of distal radial fracture, if acceptable anatomic realignment of the distal end of radius has not been achieved during closed reduction. This leads to persistent radial shortening which leads to incongruency of the D.R.U.J., and positive ulnar variance. Dysfunction of the distal radioulnar joint leads to impaired function of the wrist joint. Various surgical techniques have been developed to treat instability of the DRUJ, including distal ulna resection, partial-resection with interposition arthroplasty, and the Sauve-Kapandji procedure. Methodology: In this study twenty patients with DRUJ dysfunction with impaired rotation of forearm due to malunion of distal radius fracture with positive ulnar variance were selected. Although the patients had complete union of the fracture, they were still having pain and functional limitations 5-12 months after fracture union. They were operated using the Sauve Kapandji procedure under aseptic precautions and adequate postop care was given along with physiotherapy. We studied 20 wrists in 20 patients (15 men and 5 women), with a mean age of 45 years (range, 28 to 65 years) at the time of the operation. The mean duration of follow-up was 12 months. We studied 7 cases of left and right side in 13 cases. At the final follow-up, out of 20 patients, 15 had excellent score, 3 had good score, 2 had fair score) In all patients the pseudoarthrosis gap of the ulna was well preserved and that the stability of the proximal ulnar stump also was preserved. Conclusion: Distal radius fractures(DRF) are very common in orthopedic practice and are often accompanied by instability of the distal radio ulnar joint (DRUJ). Before the era of operative surgery closed reduction with splinting was the treatment of choice. Now a variety of treatment options are available ; closed reduction with percutaneous pinning, open reduction internal fixation with plates and screws and external fixation. Although many procedur