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; Jin-Woo Kang

doi:10.12790/jkssh.2014.19.4.167

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

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Gil, Chung, Shin, Kim, Kim, and Kang: Outcomes of the Sauve-Kapandji Procedure in Patients with Advanced Rheumatoid Arthritis

ORIGINAL ARTICLE

J Korean Soc Surg Hand 2014;19(4):167-172.

Published online: 11 December 2014

DOI: https://doi.org/10.12790/jkssh.2014.19.4.167

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, 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’ 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, E-mail: ygchung@catholic.ac.kr

Received 16 October 20143 December 2014 Accepted 9 December 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

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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).

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.

Table 1.

Mean preoperative and postoperative data

Characteristic	Preoperative data	Postoperative data	p-value
Visual analog scale for pain	4.00±1.85	0.78±0.91	0.003
Flexion (°)	35.00±32.78	27.00±12.51	0.655
Extension (°)	46.25±39.02	28.50±7.47	0.715
Pronation (°)	50.00±42.42	73.00±20.02	0.317
Supination (°)	55.00±35.35	79.00±3.16	0.317
Carpal translation index	0.34±0.06	0.33±0.06	0.199

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