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Modification of Sauvé-Kapandji Procedure for the Treatment of DRUJ Arthritis
Yoonbae Kong, MBBS; Seok-Hwan Song, PhD; Yoon-Min Lee, MS
Yeouido St. Mary Hospital, Seoul, South Korea

Purpose: The authors modified the original Sauvé-Kapandji (S-K) procedure of 1 cm leaving and 1 cm resection of distal ulna to 2 cm leaving and 2 cm resection, and experienced good results without the distal ulna-radius impingement or distal ulna instability.
Materials and Method: The clinical results of 28 patients with modified S-K procedure for the treatment of DRUJ arthritis or instability, were reviewed (9 male and 19 female). Modified S-K technique is defined as 2 cm ulna head arthrodesed to the distal radial sigmoid notch, and 2 cm gap is created with the resection of ulna proximal to the remained ulnar head. So, the distal tip of proximal ulna is leveled approximately 4 cm proximal to the level of distal radius articular surface. The arthrodesis of distal radio-ulnar joint was done using a cancellous screw with an additional Kirschner wire, occasionally. At last follow-up, radiological evaluations and the range of motion were checked.
Results: The average remained ulna head was 21 mm and the gap was also 21 mm in length. The postoperative distance between the distal tip of ulna and radius was 9 mm in average, and the final distance was 7.8 mm. The preoperative prono-supination ranges of motion of wrist were pronation 28° and supination 33°, and at last follow-up, pronation 70° and supination 65°. There were no ulno-radial impingement symptoms in these patients at last follow-up, clinically and radiologically.
Conclusion: We think the above good result of the modified S-K procedure as because of the widened initial distance between the tip of distal ulna and radius, which is interposed with the radioulnar membrane and other soft tissues, such as muscles. The interposed soft tissues prevent the impingement between ulna and radius, even though allowing the instability of the distal tip of ulna.

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