Journal List > J Korean Soc Surg Hand > v.19(4) > 1106466

J Korean Soc Surg Hand. 2014 Dec;19(4):167-172. Korean.
Published online December 31, 2014.  https://doi.org/10.12790/jkssh.2014.19.4.167
Copyright © 2014. The Korean Society for Surgery of the Hand
Outcomes of the Sauve-Kapandji Procedure in Patients with Advanced Rheumatoid Arthritis
Ho-Jin Gil, Yang-Guk Chung, Seung-Han Shin, Dong-Hyun Kim, Hyoung-Jin Kim and Jin-Woo Kang
Department of Orthopedic Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

Correspondence to: Yang-Guk Chung. Department of Orthopedic Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea. TEL: +82-2-2258-2837, FAX: +82-2-535-9834, Email: ygchung@catholic.ac.kr
Received October 16, 2014; Revised December 03, 2014; Accepted December 09, 2014.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Purpose

We evaluated the clinical and radiographic outcomes of the Sauve-Kapandji procedure for the treatment of advanced rheumatoid arthritis.

Methods

Twenty-severn wrists in twenty-two patients were treated for advanced rheumatoid arthritis with Sauve-Kapandji procedure. Patients were evaluated in terms of wrist pain, bony union, instability of the ulnar proximal stump, ulnar stump pain, range of motion and other complications. Pain was evaluated using a visual analog scale. Radiographic evaluation included calculation of the carpal translation index to assess the extent of ulnar translation of the carpus.

Results

The average visual analogue scale score improved from 4±1.85 preoperatively to 0.78±0.91 at the last follow-up (p=0.003). Bone unions in distal radioulnar joint were obtained in all 22 patients, 27 wrists at mean 10.74 weeks (range, 6-28 weeks) after operation. The supination/pronation range of motion was changed from 55/50 degrees preoperatively to 79/73 degrees at postoperative 6 months follow up (p=0.32). The mean carpal translation index did not change after the operation.

Conclusion

The Sauve-Kapandji procedure is a reliable methods of relieving pain, preserving range of motion (supination/pronation) and preventing ulnar translation of the carpus in managements of the severely destroyed distal radioulnar joints in rhematoid arthritis.

Keywords: Rheumatoid arthritis; Distal radioulnar joint arthritis; Sauve-Kapandji procedure; Clinical outcome

Figures


Fig. 1
The carpal translation index is calculated as the ratio of the distance between the center of the head of the capitate and a line drawn through the radial cortex of the radius B to the length of the third metacarpal A. This index normally measures 0.28±0.03 (mean and standard deviation).
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Fig. 2
(A) Initial radiographs of right wrist of 40-year-old female patient showed rheumatoid arthritis. (B) Immediate postoperative radiographs. (C) Radiographs taken at postoperative 2 year showed complete osseus union.
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Tables


Table 1
Mean preoperative and postoperative data
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