Sauvé-Kapandji and Darrach Salvage Procedure Rates for Distal Radioulnar Joint Arthritis and Instability
Reece Moore, BS1, Ryan O'Leary, BA1, Sami Tarabishy, MD1 and Fernando Herrera, MD2, (1)Medical University of South Carolina, Charleston, SC, (2)Division of Plastic Surgery, Medical University of South Carolina, Division of Plastic Surgery, Charleston, SC
Background: Distal radioulnar joint (DRUJ) instability and arthritis is often a painful and functionally limiting pathology. Two common salvage procedures for DRUJ dysfunction are the Darrach and Sauvé-Kapandji (S-K) procedures. This study aims to provide an analysis of national Darrach and S-K procedure utilization rates and patient demographics.
Methods: A national ambulatory surgery database, the 2018 Nationwide Ambulatory Surgery Sample (NASS), was filtered for Darrach and S-K procedure encounters. Data related to patient demographics and past medical history, indications for DRUJ salvage, and concurrent hand/wrist procedures were collected.
Results: Database analysis revealed 1044 Darrach and 223 S-K procedure encounters. Patients undergoing Darrach procedures were older (60 vs 57, p = 0.002) and more likely to be female (66.1% vs 54.6%, p<0.05). Patients <35 years-old underwent S-K procedures at greater rates compared to Darrach (13.9% vs 8.6%, p<0.05). Primary osteoarthritis proved to be the most common indication for DRUJ salvage (64.8%) compared to rheumatoid arthritis (23.2%) and post-traumatic osteoarthritis (12.0%). Darrach and S-K procedures were accompanied by a secondary procedure at rates of 64% and 41%, respectively. The most common secondary procedures were tendon transfer, implant removal, neuroplasty and nerve transection, and wrist arthroscopy.
Conclusions: Patient age and sex are associated with DRUJ salvage procedure selection. S-K procedures are used higher rates in male and younger patient populations. Further, primary osteoarthritis and rheumatoid arthritis are the main underlying pathologies for Darrach and S-K procedures.
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