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Lamont S, Debkowska M, Johnsen P, Froehle A, Cotterell IH, Isaacs J. Outcomes of Darrach and Sauvé-Kapandji Procedures: A Systematic Review. Hand (N Y) 2024; 19:68-73. [PMID: 35815646 PMCID: PMC10786111 DOI: 10.1177/15589447221107697] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
BACKGROUND To review the available literature on Darrach and Sauvé-Kapandji (SK) procedures and perform a systematic review to identify differences in clinical outcomes. We hypothesized that SK would have a higher complication rate without significant clinical benefit. METHODS A literature search was conducted using PubMed, EMBASE, Cochrane Library, and SCOPUS (from inception to January 2020) to identify studies evaluating outcomes of Darrach and SK procedures. Primary outcome measures included the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, range of motion, grip strength, complications, and overall satisfaction. RESULTS A total of 103 articles were identified and screened, and of these, 44 full-text articles were used for data extraction and qualitative analysis. Outcomes were similar for QuickDASH scores, grip strength, and range of motion, as was overall satisfaction. Specifically, satisfaction rates for stabilized SK and Darrach procedures in patients without rheumatoid arthritis were comparable at 70.2% and 72.6%, respectively. Average QuickDASH scores were similar (21 for Darrach and 29 for SK). Mechanical symptoms due to stump instability occur with either procedure but were higher with the Darrach procedure (12.5% compared with 6.8%). The SK had more surgery-related complications such as nonunions (2.3%), symptomatic hardware, and reoperations (6.8% compared with 3.2%). CONCLUSIONS Both Darrach and SK procedures provide comparable satisfaction rates regardless of the underlying pathology. Improvement in range of motion, strength, and overall function is similar for both procedures; however, the reoperation rate is higher with SK.
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Affiliation(s)
- Sarah Lamont
- Virginia Commonwealth University Health System, Richmond, USA
| | | | - Parker Johnsen
- Virginia Commonwealth University Health System, Richmond, USA
| | | | | | - Jonathan Isaacs
- Virginia Commonwealth University Health System, Richmond, USA
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Suganuma S, Tada K, Takagawa S, Yasutake H, Shimanuki K, Tsuchiya H. Radiological Outcomes of the Simplified Sauvé-Kapandji Procedure for Osteoarthritis of the Distal Radioulnar Joint. J Hand Surg Asian Pac Vol 2022; 27:541-547. [PMID: 35674260 DOI: 10.1142/s2424835522500552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: We have been using a simplified Sauvé-Kapandji (SK) procedure using a headless compression screw for the treatment of osteoarthritis (OA) of the distal radio-ulnar joint (DRUJ). Unlike a standard SK procedure, the simplified SK procedure does not require exposure of the DRUJ to prepare the opposing surfaces of the sigmoid fossa and the ulnar head or any procedures to stabilise the proximal stump of the ulna. The aim of this study is to report the radiological outcomes of the simplified SK procedure. Methods: We retrospectively reviewed data of all patients who underwent a simplified SK procedure for osteoarthritis of the DRUJ at our hospital between October 2008 and September 2020 with a follow-up of at least 25 weeks. Baseline demographic and clinical characteristics were investigated. We also measured radiographic parameters and performed statistical analyses to evaluate the shelf-forming region, ulnar stump and deviation of the carpal region. Results: Our study included 10 patients with a mean follow-up of 52.3 weeks. There was no instance of complications such as nonunion of DRUJ arthrodesis, callus formation at ulnar pseudoarthrosis and painful instability at the proximal stump of the ulna. According to the Wilcoxon signed rank test, no radiographic parameters significantly changed during the follow-up period. There was a significant negative correlation between radioulnar width and the variation of ulnar translation index. Conclusions: All radiographic parameters were well maintained, at least during the short follow-up period. There was no instance of nonunion of DRUJ arthrodesis. The simplified SK with simple headless compression screw insertion may be a reliable method for treating OA of the DRUJ. Level of Evidence: Level IV (Therapeutic).
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Affiliation(s)
- Seigo Suganuma
- Department of Orthopaedic Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Kaoru Tada
- Department of Orthopaedic Surgery, Kanazawa University Hospital, Kanazawa, Japan
| | - Shingo Takagawa
- Department of Orthopaedic Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Hidetoshi Yasutake
- Department of Orthopaedic Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Keito Shimanuki
- Department of Orthopaedic Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University Hospital, Kanazawa, Japan
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Suzuki T, Terasaka Y, Tomoyuki K, Hagiwara T, Masuda S, Kimura H, Matsumura N, Iwamoto T. Change of wrist motion before and after fixation of the distal radioulnar joint and resection of the distal ulna in a cadaveric model. Mod Rheumatol 2022; 32:136-140. [PMID: 33813991 DOI: 10.1080/14397595.2021.1910175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/25/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Recent study suggests the distal radioulnar joint (DRUJ) plays a role in flexion and extension of the wrist. We examined the range of motion (ROM) of the wrist before and after DRUJ fixation and distal ulnar resection in a cadaveric model. METHODS Twenty fresh cadaveric human wrists were transected and treated with two sequential interventions: (a) DRUJ fixation, and (b) distal ulnar resection. The angle of maximum flexion and extension of the wrist was measured before and after the procedures. Maximum force to the wrist was determined before the procedures using a digital pressure monitor. RESULTS The mean maximum wrist flexion ROM was 84.2° before the procedures. The ROM decreased to 82.5° after DRUJ fixation, and significantly increased to 88.2° after subsequent resection of the distal ulna. The mean maximum wrist extension ROM before the procedures was 73.5°. The ROM decreased to 71.6° after DRUJ fixation, and significantly increased to 77.1° after subsequent resection of the distal ulna. CONCLUSIONS Motion of the wrist is affected by DRUJ. This study suggests that the DRUJ might contribute to the ROM in flexion and extension of the wrist.
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Affiliation(s)
- Taku Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yukinori Terasaka
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kato Tomoyuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takeshi Hagiwara
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shusuke Masuda
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroo Kimura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Noboru Matsumura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takuji Iwamoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
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Kato T, Suzuki T, Kameyama M, Okazaki M, Morisawa Y, Nishiwaki M, Nakamura T, Sato K, Iwamoto T. Range of Motion after the Sauvé-Kapandji and Darrach Procedures without Extensor Tendon Rupture. J Wrist Surg 2021; 10:190-195. [PMID: 34109060 PMCID: PMC8169168 DOI: 10.1055/s-0040-1721452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/28/2020] [Indexed: 10/22/2022]
Abstract
Background Previous study demonstrated that distal radioulnar joint (DRUJ) plays a biomechanical role in extension and flexion of the wrist and suggested that fixation of the DRUJ could lead to loss of motion of the wrist. Little is known about the pre- and postoperative range of motion (ROM) after the Sauvé-Kapandji (S-K) and Darrach procedures without tendon rupture. To understand the accurate ROM of the wrist after the S-K and Darrach procedures, enrollment of patients without subcutaneous extensor tendon rupture is needed. Purpose This study aimed to investigate the pre- and postoperative ROM after the S-K and Darrach procedures without subcutaneous extensor tendon rupture in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Methods This retrospective study included 36 patients who underwent the S-K procedure and 10 patients who underwent the Darrach procedure for distal radioulnar joint disorders without extensor tendon rupture. Pre- and postoperative ROMs after the S-K and Darrach procedures were assessed 1 year after the surgery. Results In the S-K procedure, the mean postoperative ROM of the wrist flexion (40 degrees) was significantly lower than the mean preoperative ROM (49 degrees). In wrist extension, there were no significant differences between the mean preoperative ROM (51 degrees) and postoperative ROM (51 degrees). In the Darrach procedure, the mean postoperative ROM of the wrist flexion and extension increased compared with the mean preoperative ROM; however, there were no significant differences. Conclusion In the S-K procedure, preoperative ROM of the wrist flexion decreased postoperatively. This study provides information about the accurate ROM after the S-K and Darrach procedures. Level of Evidence This is a Level IV, therapeutic study.
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Affiliation(s)
- Tomoyuki Kato
- Department of Orthopaedic Surgery, Ogikubo Hospital, Suginami-ku, Tokyo, Japan
| | - Taku Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Makoto Kameyama
- Department of Orthopaedic Surgery, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Masato Okazaki
- Department of Orthopaedic Surgery, Ogikubo Hospital, Suginami-ku, Tokyo, Japan
| | - Yasushi Morisawa
- Department of Orthopaedic Surgery, National Hospital Organization Saitama Hospital, Wako, Saitama, Japan
| | - Masao Nishiwaki
- Department of Orthopaedic Surgery, Kawasaki Municipal Hospital, Kawasaki, Japan
| | - Toshiyasu Nakamura
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Kazuki Sato
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takuji Iwamoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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Tsai TC, Chen CC, Huang HK, Wang JP. Modified Sauve-Kapandji Procedure Using Iliac Bone Graft for Giant Cell Tumor of the Distal Ulna: Stabilizing With Two-Screw Fixation: A Case Report. JBJS Case Connect 2020; 9:e0299. [PMID: 31211751 DOI: 10.2106/jbjs.cc.18.00299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE We describe a 33-year-old man who had a giant cell tumor in the ulnar head treated with wide resection and reconstructed using the modified Sauve-Kapandji procedure with an iliac crest bone graft as ulnar support. CONCLUSIONS Due to the destructive nature of the tumor and the important role played by the ulnar head in the distal radioulnar joint (DRUJ), treatment of the giant cell tumor in the distal ulna is a challenge. The modified Sauve-Kapandji procedure is an effective technique to restore DRUJ function, which is performed as an ulnar support arthroplasty. Using an iliac crest bone graft as ulnar support in reconstruction surgery could be a practical method after the ulnar head has been resected.
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Affiliation(s)
- Ting-Chien Tsai
- Department of Orthopaedics, Chiayi Christian Hospital, Chiayi, Taiwan
| | - Chien-Chin Chen
- Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.,Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Hui-Kuang Huang
- Department of Orthopaedics, Chiayi Christian Hospital, Chiayi, Taiwan.,Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Food Nutrition, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Jung-Pan Wang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Ordinary Cannulated Compression Screws or Headless Cannulated Compression Screws? A Synthetic Bone Biomechanical Research in the Internal Fixation of Vertical Femoral Neck Fracture. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4898301. [PMID: 29850523 PMCID: PMC5925079 DOI: 10.1155/2018/4898301] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 01/23/2018] [Accepted: 02/27/2018] [Indexed: 11/25/2022]
Abstract
Purpose The purpose of this study is to verify whether the headless cannulated compression screw (HCCS) has higher biomechanical stability than the ordinary cannulated compression screw (OCCS) in the treatment of vertical femoral neck fractures. Materials and Methods 30 synthetic femur models were equally divided into 2 groups, with 50°, 60°, and 70° Pauwels angle of femoral neck fracture, under 3D printed guiding plates and C-arm fluoroscopic guidance. The femur molds were fixed with three parallel OCCSs as OCCS group and three parallel HCCSs as HCCS group. All specimens were tested for compressive strength and maximum load to failure with a loading rate of 2 mm/min. Results The result showed that there was no significant difference with the compressive strength in the Pauwels angle of 50° and 60°. However, we observed that the maximum load to failure with the Pauwels angle of 50°, 60°, and 70° and the compressive strength with 70° of HCCS group showed better performance than the OCCS group. Conclusion HCCS performs with better biomechanical stability than OCCS in the treatment of vertical femoral neck fracture, especially with the Pauwels angle of 70°.
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Liu S, Sun L, Chai Y, Fan C, Xu Y. [Clinical application progress of the Sauvé-Kapandji procedure]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2017; 31:1131-1134. [PMID: 29798574 DOI: 10.7507/1002-1892.201702087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To review the clinical application progress of the Sauvé-Kapandji procedure. Methods The indications, techniques, effectiveness, and modifications of the Sauvé-Kapandji procedure were analyzed and evaluated by an extensive review of the relevant literature. Results The Sauvé-Kapandji procedure can be applied for various disorders of the distal radioulnar joint. Risk of series of complications exist, which might be reduced by modification of the procedure. Conclusion The Sauvé-Kapandji procedure, as a salvage operation, can be a good alternative by meticulous manipulation for appropriate cases with distal radioulnar joint disorders.
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Affiliation(s)
- Shenghe Liu
- Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai, 200233, P.R.China
| | - Luyuan Sun
- Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai, 200233, P.R.China
| | - Yimin Chai
- Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai, 200233, P.R.China
| | - Cunyi Fan
- Department of Orthopaedics, Shanghai Sixth People's Hospital, Shanghai, 200233, P.R.China
| | - Yaozeng Xu
- Department of Orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou Jiangsu, 215006,
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