Total Wrist Arthrodesis with the Sauve-Kapandji Procedure in the Rheumatoid Arthritis

Abstract

Purpose: To evaluate the functional results of total wrist arthrodesis with the Sauve-Kapandji procedure in the rheumatoid arthritis. Materials and Methods: The clinical results of twenty wrists of 17 patients who underwent total wrist arthrodesis with the Sauve-Kapandji procedure for the treatment of the rheumatoid arthritis during the period of February 1996 to May 2003 were analyzed. The patients who were observed for more than 12 months postoperatively were chosen as subjects and the mean follow-up period was 42 months (range, 13 to 100 months). At last follow-up, radiological and functional evaluation were done. For the functional evaluation, the standard patient review questions of Weiss et al. and the Buck-Gramcko/Lohmann score were used. Results: The mean time to clinical fusion of the wrist was 6 weeks. The postoperative range of motion is pronation , supination . The standard patient review questions of Weiss et al. revealed that 17 cases (85%) were satisfied with the functional results of the procedure. 16 cases (80%) wished that the procedure had been done earlier. The standard patient review questions also showed that maximum improvement in function after the procedure required an average of 6 months (range, 1 to 30 months). On a scale of 1 to 10, the mean score of the subjective overall functional evaluation by the patients was 8.25 points (range, 5-10 points). The mean Buck-Gramcko/Lohmann score for the objective functional evaluation was 8.7 points (range, 1-10 points) out of 10 points, corresponding to good result. Conclusion: For the treatment of the advanced rheumatoid arthritis of wrist involving radio-carpal, midcarpal, and distal radio-ulnar joint, total wrist arthrodesis with the Sauve-Kapandji procedure was a reliable treatment method. These procedures offer satisfactory subjective and objective functions with few complications.