Treatment of obsolete volar dislocation of the distal radioulnar joint by Sauvé-Kapandji procedure

Abstract

Objective To evaluate the Sauve-Kapandji procedure in the treatment of obsolete volar dislocation of the distal radiounlar joint (DRUJ).Methods From March 2008 to March 2012,we treated 3 patients with obsolete DRUJ volar dislocation using the Sauve-Kapandji procedure.They were 2 men and one woman,with an average age of 45 years (from 31 to 45 years).They all presented with limited rotation of the wrist and pain.The surgical protocol was developed after the diagnosis was confirmed by X-ray and 3D-CT scan before operation.The clinical outcomes were assessed postoperatively by visual analogue scale (VAS) score,range of motion (ROM) of the wrist,grip strength,Disabilities of the Arm,Shoulder and Hanl (DASH) and Mayo scores.Results The 3 patients were followed up for 1.5 to 3.0 years (2.3 years on average).Their dislocation was corrected with no occurrence of instability of the proximal ulna.The VAS score decreased from preoperative 5.3 points to postoperative 2.0 points.The wrist flexion increased from preoperative 29.3° to postoperative 60.7°,the wrist extension from preoperative 26.0° to postoperative 53.7°,the radial deviation from preoperative 11.7° to postoperative 19.0°,the ulnar deviation from preoperative 7.0° to postoperative 17.7°,the DASH score from preoperative 33 points to postoperative 73 points,the Mayo score from preoperative 41 points to postoperative 82 points,and the grip strength from preoperative 29.3 ％ to postoperative 72.7％ of the healthy side.Conclusion Sauve-Kapandji procedure is a fine treatment of DRUJ volar dislocation,because it leads to satisfactory clinical outcomes in addition to preservation of the ulnar head and triangular fibrocartilage complex. Key words: Carpal joints; Dislocation; Range of motion, articular; Hand strength; Sauve-Kapandji procedure