Results of the modified Sauve-Kapandji procedure in the treatment of chronic posttraumatic derangement of the distal radioulnar joint

We reviewed the results of a modified Sauve-Kaprandji procedure with tenode sis of the flexor carpi ulnaris to the carpus in eighteen patients who had chronic derangement of the distal radioulnar joint. There were fourteen men and four women. The mean supination of the forearm lead improved from 16 d egrees (range, 0 to 75 degrees) preoperatively to 76 degrees (range, 40 to 90 degrees) at Be time of the latest follow-up, and the mean pronation had improved from 42 degrees (range, 0 to 80 degrees) preoperatively to 81 degr ees (range, 60 to 90 degrees) at the dime of follow-up. Pain relief was sat isfactory and the mean grip strength had improved front 36 percent of that on the unaffected side preoperatively to 73 percent at the time of follow-u p, One patient had moderate pain over the ulnar stump associated with resid ual volar instability of the proximal ulnar segment, and he had a tenodesis of the extensor carpi ulnaris as a second procedure, Another patient had m ild instability of the stump only after he had a second operation, which,va s am excision of a bone mass (ossification) in the resected area. The ulnar stump was stable in sixteen patients. Eight of the eleven patients who had performed heavy manual labor before th e injury were able to return to work full-time without restrictions. Accord ing to a modification of the wrist-scoring system of the Mayo Clinic, at a mean of four years and two months (range, two years to eight years and four months), six patients had an excellent result; seven, a good result; four, a fair result; and one, a poor result, On the basis of OUT findings, we be lieve that the index operation is an excellent salvage procedure for the tr eatment of chronic posttraumatic derangement of the distal radioulnar joint , especially when nonoperative treatment has been unsuccessful and rotation of the forearm is severely limited.