What is sauve Kapandji procedure?

What is sauvé Kapandji procedure?

In 1936, Sauvé and Kapandji described a procedure that included an arthrodesis across the distal radioulnar joint and created a pseudarthrosis of the ulna, proximal to the fusion, to restore pronation and supination.

What is distal radioulnar?

Distal radioulnar joint (DRUJ) is a pivot type synovial joint located between the radius and the ulna just proximal to the wrist joint and assists in pronation and supination of the forearm. The joint is critical to the working of the forearm as a mechanical unit.

What is the DRUJ?

The distal radioulnar joint (DRUJ) is part of the complex forearm articulation that includes proximal radioulnar joint (PRUJ), forearm bones, and interosseous membrane (IOM) allowing pronosupination. It is functionally and anatomically integrated with the ulnocarpal articulation of wrist.

What is a wafer procedure?

The arthroscopic wafer procedure involves debridement of the central triangular fibrocartilage complex tear, along with debridement of the distal pole of the ulna causing the impaction. Debridement of the ulna arthroscopically is taken down to a level at which the patient is ulnar neutral or slightly ulnar negative.

Is the distal radioulnar joint part of the wrist?

The distal radioulnar articulation is the one of the two closest to the wrist and hand. The distal radioulnar articulation pivot-joint formed between the head of ulna and the ulnar notch on the lower extremity of radius.

Which bones contribute to the wrist joint?

The radiocarpal joint is a synovial joint formed between the radius, its articular disc and three proximal carpal bones; the scaphoid, lunate and triquetral bones.

How do you fix DRUJ?

Treatment include splinting, ORIF of fractures and repair of torn ligaments and TFCC by arthroscopy or open methods. In late presentations, instability is addressed by various techniques which have been described. DRUJ arthroplasty is emerging as a treatment in cases of arthrosis of the joint.

How do you treat DRUJ?

Surgery should be considered for DRUJ instability to recover bone and ligament injuries if nonsurgical treatment fails to restore forearm stability and function. To recover bone deformities, osteotomies of the radius,14,15 ulna,16 or, in some cases, sigmoid notch osteoplasty17 are used.

What is wafer resection of the distal ulna?

Partial resection of the distal ulna (wafer resection) has been used to treat patients with symptomatic tears of the triangular fibrocartilage complex or mild ulna impaction syndrome.

How long does it take to recover from ulnar shortening surgery?

Downtime: With this injury, you are in the long arm splint for 6 weeks and then it is shortened and this is worn for approximately 4 more weeks depending on your healing. You will not be able to use your hand post-surgery for any work or self-care tasks for 6-8 weeks depending on the type of work you are returning to.

What does it mean to articulate distally?

Distally, the ulnar notch of the radius and the ulnar head articulate at another pivot joint allowing for supination and pronation. The radius articulates with the wrist via the scaphoid and lunate bones. This articulation is a condyloid or “ellipsoidal” joint which allows the wrist to move in two planes.

How does the Sauve Kapandji procedure differ from Darrach?

The Sauvé-Kapandji differs from the Darrach procedure in that it preserves ulnar support of the wrist, as the distal radioulnar ligaments and ulnocarpal ligaments are maintained. Aesthetic appearance is also superior after the S-K procedure, as the normal prominence of the ulnar head, most noticeable when the forearm is in pronation, is maintained.

How is the druj performed on the wrists?

A simultaneous corrective osteotomy of the distal radius was performed in 10 wrists: eight that were sequelae after a fracture of the distal radius and two wrists with a Madelung deformity. Surgical Technique The DRUJ is approached dorsally through an inverted V incision centered over the ulnar head (Figs. 1a–d).

Which is better druj or ulnar head resection?

The combination of arthrodesis of the DRUJ and ulnar resection-osteotomy proximal to the arthrodesis, for restoration of pronation and supination of the forearm, has the advantage over ulnar head resection of preserving ulnar support of the wrist, as the distal radioulnar ligaments and ulnocarpal ligaments are preserved.

Are there any complications with the S-K procedure?

However, the S-K is not free of possible complications, such as nonunion or delayed union of the arthrodesis, fibrous or osseous union at the pseudoarthrosis, and painful instability at the proximal ulna stump. All of these complications can be prevented if a careful surgical technique is used.