However, it might compromise some indices of the forearm such as grip strength. The SK procedure could result in acceptable radiologic and functional outcomes for the management of post-traumatic DRUJ problems. At the last follow-up, radiologic union was observed in all the patients but one. Based on the MMWS, the functional outcome was categorized as excellent in two patients, good in five patients, and fair in one patient. The mean grip strength was 45.6 ± 14.1 Ib for the injured hand and 75.4 ± 30 Ib for the non-injured hand (P = 0.012). The mean ulnar and radial deviations were 20.6° and 17.5°, respectively. The mean extension, flexion, supination, and pronation of the patients were 67.5°, 65°, 77.5°, and 78.1°, respectively. The grip strength of the injured hand was compared with the grip strength of contralateral hand.

The forearm range of motion and Mayo Modified Wrist Score (MMWS) were used for the clinical evaluation of the outcomes. The radiologic outcomes were evaluated using the assessment of union, ulnar variation, and radial deviation. In a retrospective study, patients with post-traumatic derangement of the DRUJ that underwent the SK procedure were included. Here, we evaluated the radiologic and clinical outcomes of the SK procedure in eight patients with post-traumatic disorders of DRJU. Amongst them, Sauve-Kapandji (SK) procedure has shown promising results yet, it is not infallible. Several procedures have been described for the management of post-traumatic disorders of the distal radioulnar joint (DRUJ). It was concluded that wrist arthrodesis is applicable to a diversity of wrist pathologies which imply in pain and unstability, with easily reproducible results, without significantly affecting the global upper limb function, despite the relative loss of power, mainly due to the pre-existing factor. Relative loss of grip strength (61% from normal) and digital pinch (70% from normal) were observed, but final results were considered as satisfactory on the functional tests, in accordance to the literature. All patients presented pain improvement, with a different pattern, as compared to the preoperative period and all of those with lighter activities resumed their previous occupation. Pseudarthrosis was observed in one single case, and eventually healed after reoperation for bone grafting. Primary healing was obtained in 50 wrists (98%) in eight weeks on average. The arthrodesis was performed in 14º extension and 8º ulnal deviation, on average. The subjective method was based on the evaluation by the patients and the objective method on analysis of radiographs and functional tests simulating all different functions of the upper limb. Both subjective and objective methods were used in the evaluation.

In all cases the arthrodesis was performed with rigid internal fixation with a dynamic compression plate postoperative follow-up ranged from 6 to 201 months (average: 73 months). The functional results of 51 wrist arthrodesis carried out in 49 patients with different regional pathologies are analyzed. It was concluded that Sauvé-Kapandjis technique is efficient to treat derrangements of the distal radioulnar joint, since it does not imply significant functional loss. The X-ray view under strain showed that all patients presented dislocation of the ulna towards the radius, but this apparently did not interfere with function. The distal radioulnar arthrodesis healed uneventfully in 9 cases, independently from the type of fixation used. All patients improved from their complaints and the final results were considered satisfactory (excellent or good) in 8, and unsatisfactory (regular) in 2. All were submitted to clinical, functional and radiographic evaluation at 28.3 months after the operation on average, particular attention being paid to an anteroposterior X-ray view with the hand in a moderate hand grip effort. The patients average age by the time of the operation was 37.8 years (range: 19 - 68 years). Derrangements resulted from trauma (7), degeneration (2) and congenital disease (1) and the main preoperative complaints were pain, limitation of pronation and supination and deformity. A retrospective study of 10 cases of derrangement of the distal radioulnar joint treated with the technique of Sauvé- Kapandji was carried out.

Sauve et protege cast