J Korean Soc Surg Hand.  2014 Dec;19(4):167-172. 10.12790/jkssh.2014.19.4.167.

Outcomes of the Sauve-Kapandji Procedure in Patients with Advanced Rheumatoid Arthritis

• Gil HJ
• Chung YG
• Shin SH
• Kim DH
• Kim HJ
• Kang JW

• KMID: 1896905
• DOI: http://doi.org/10.12790/jkssh.2014.19.4.167

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.

Keyword

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

MeSH Terms

Arthritis
Arthritis, Rheumatoid*
Follow-Up Studies
Humans
Joints
Range of Motion, Articular
Visual Analog Scale
Wrist

Figure

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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.

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