Treatment of traumatic ulnar styloid impaction syndrome by Sauvé-Kapandji procedure_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANGJun ¹ , LIUGang ^1△ , HUANGFuguo ² , TANGShitian ¹ , ZHANGDingwei ¹ ,  WANGLihui ¹

1. Department of Orthopedics, Mianyang Central Hospital, Mianyang Sichuan, 621000, P.R.China;
2. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding?author：

WANGLihui, Email: liugang618@163.com

Keywords：

Ulnar styloid impaction syndrome; Sauvé-Kapandji procedure; wrist; functional reconstruction

DOI：

10.7507/1002-1892.201607041

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Objective To evaluate the effectiveness of Sauvé-Kapandji procedure in the treatment of traumatic ulnar styloid impaction syndrome. Methods Between June 2010 and January 2013, 12 patients with traumatic ulnar styloid impaction syndrome were treated by Sauvé-Kapandji procedure. There were 4 men and 8 women, with an average age of 58.9 years (range, 50-69 years). The disease was caused by traffic accident in 1 case, and by falling from height in 11 cases. All patients had dislocation of the distal radioulnar joint, and 7 patients also had old fractures of the distal radius. The main clinical symptoms were pain and limited activity of the wrist joint, and the disease duration was 2-4 months (mean, 3.5 months). The visual analogue scale (VAS) was 6.2±1.4. The clinical outcomes were assessed by VAS, range of motion (ROM) of the wrist, grip strength, Evans score, and X-ray film of wrist joint during follow-up. Results All patients obtained healing of incision by first intention and were followed up 37-73 months (mean, 58.4 months); no complication of infection, blood vessel injury, or nerves injury occurred. VAS was 1.2±1.0 at the final follow-up, showing significant difference when compared with preoperative one (t=9.950,P=0.000). The ROM of the affected wrist joint in flexion, extension, ulnar deviation, forearm pronation and supination were improved, but the ROM of the affected side were significantly less than those of normal side (P<0.05). No significant difference was found in the grip strength and Evans score between the affected side and normal side (t=–0.885,P=0.386;t=–1.969,P=0.062). According to Evans scores, the results were excellent in 8 cases, good in 3 cases, and fair in 1 case, with an excellent and good rate of 91.7%. Postoperative radiographs showed bony healing in all patients, with the average healing time of 3.5 months (range, 3-6 months). The instability of proximal ulna occurred in 3 cases. Conclusion Sauvé-Kapandji procedure is a reliable remedy method for traumatic ulnar styloid impaction syndrome, with favorable improvement in wrist pain and forearm rotation. However, the surgical indications for Sauvé-Kapandji procedure should be strictly controlled.

Citation： WANGJun, LIUGang, HUANGFuguo, TANGShitian, ZHANGDingwei, WANGLihui. Treatment of traumatic ulnar styloid impaction syndrome by Sauvé-Kapandji procedure. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(2): 155-159. doi: 10.7507/1002-1892.201607041 Copy

1.	Doherty C, Gan BS, Grewal R. Ulnar shortening osteotomy for ulnar impaction syndrome. J Wrist Surg, 2014, 3(2): 85-90.
2.	陳君蓉, 但倩, 張滔, 等. X線平片、CT、MRI對尺骨撞擊綜合征的對照研究. 華西醫學, 2015, 30(3): 488-491.
3.	Lee SK, Kim KJ, Cha YH, et al. Conservative treatment is sufficient for acute distal radioulnar joint instability with distal radius fracture. Ann Plast Surg, 2016, 77(3): 297-304.
4.	Barbaric K, Rujevcan G, Labas M, et al. Ulnar shortening osteotomy after distal radius fracture malunion: review of literature. Open Orthop J, 2015, 9: 98-106.
5.	夏平光, 蔡賢華, 王慶, 等. 橈尺韌帶關節內重建術治療橈尺遠側關節陳舊性脫位. 中國修復重建外科雜志, 2014, 28(2): 205-208.
6.	Reissner L, B?ttger K, Klein HJ, et al. Midterm results of semiconstrained distal radioulnar joint arthroplasty and analysis of complications. J Wrist Surg, 2016, 5(4): 290-296.
7.	Haferkamp H. Kapandji-Sauvé procedure with distal radioulnar fusion and segmental resection of the ulna. Oper Orthop Traumatol, 2012, 24(1): 13-22.
8.	唐詩添, 劉剛, 張定偉, 等. 帶血管蒂頭狀骨瓣移位治療終末期月骨缺血性壞死的遠期療效. 中國修復重建外科雜志, 2014, 28(8): 925-928.
9.	陳振兵, 洪光祥, 王發斌. 上肢功能評定表. 中國修復重建外科雜志, 2004, 18(6): 520-521.
10.	McGinley JC, Gold G, Cheung E, et al. MRI detection of forearm soft tissue injuries with radial head fractures. Hand (NY), 2014, 9(1): 87-92.
11.	Daneshvar P, Willing R, Pahuta M, et al. Osseous anatomy of the distal radioulnar joint: an assessment using 3-dimensional modeling and clinical implications. J Hand Surg (Am), 2016, 41(11): 1071-1079.
12.	Malone PS, Shaw OG, Lees VC. Anatomic relationships of the distal and proximal radioulnar joints articulating surface areas and of the radius and ulna bone volumes-implications for biomechanical studies of the distal and proximal radioulnar joints and forearm bones. Front Bioeng Biotechnol, 2016, 4: 61.
13.	Malone PS, Cooley J, Morris J, et al. The biomechanical and functional relationships of the proximal radioulnar joint, distal radioulnar joint, and interosseous ligament. J Hand Surg (Eur Vol), 2015, 40(5): 485-493.
14.	Malone PS, Cooley J, Terenghi G, et al. The effect of elbow extension on the biomechanics of the osseoligamentous structures of the forearm. J Hand Surg (Am), 2015, 40(9): 1776-1784.
15.	Daecke W, Martini AK, Streich NA. Kapandji-Sauvé procedure for chronic disorders of the distal radioulnar joint with special regard to the long-term results. Handchir Mikrochir Plast Chir, 2003, 35(3): 164-169.
16.	Czermak C, Wittemann M, Germann G, et al. Functional results after the Kapandji-Sauvé operation for salvage of the distal radioulnar joint. Handchir Mikrochir Plast Chir, 2007, 39(6): 403-408.
17.	Ross M, Thomas J, Couzens G, et al. Salvage of the unstable Sauvé-Kapandji procedure: a new technique. Tech Hand Up Extrem Surg, 2007, 11(1): 87-92.
18.	Zimmermann R, Gabl M, Angermann P, et al. Long-term results after a modified Sauvé-Kapandji procedure. Report on 105 post-traumatic cases. Unfallchirurg, 2003, 106(7): 561-565.
19.	王云亭, 林朋, 史振才, 等. Sauvé-Kapandji 手術治療橈尺遠側關節脫位的療效. 中華手外科雜志, 2000, 16(3): 146-148.

1. Doherty C, Gan BS, Grewal R. Ulnar shortening osteotomy for ulnar impaction syndrome. J Wrist Surg, 2014, 3(2): 85-90.
2. 陳君蓉, 但倩, 張滔, 等. X線平片、CT、MRI對尺骨撞擊綜合征的對照研究. 華西醫學, 2015, 30(3): 488-491.
3. Lee SK, Kim KJ, Cha YH, et al. Conservative treatment is sufficient for acute distal radioulnar joint instability with distal radius fracture. Ann Plast Surg, 2016, 77(3): 297-304.
4. Barbaric K, Rujevcan G, Labas M, et al. Ulnar shortening osteotomy after distal radius fracture malunion: review of literature. Open Orthop J, 2015, 9: 98-106.
5. 夏平光, 蔡賢華, 王慶, 等. 橈尺韌帶關節內重建術治療橈尺遠側關節陳舊性脫位. 中國修復重建外科雜志, 2014, 28(2): 205-208.
6. Reissner L, B?ttger K, Klein HJ, et al. Midterm results of semiconstrained distal radioulnar joint arthroplasty and analysis of complications. J Wrist Surg, 2016, 5(4): 290-296.
7. Haferkamp H. Kapandji-Sauvé procedure with distal radioulnar fusion and segmental resection of the ulna. Oper Orthop Traumatol, 2012, 24(1): 13-22.
8. 唐詩添, 劉剛, 張定偉, 等. 帶血管蒂頭狀骨瓣移位治療終末期月骨缺血性壞死的遠期療效. 中國修復重建外科雜志, 2014, 28(8): 925-928.
9. 陳振兵, 洪光祥, 王發斌. 上肢功能評定表. 中國修復重建外科雜志, 2004, 18(6): 520-521.
10. McGinley JC, Gold G, Cheung E, et al. MRI detection of forearm soft tissue injuries with radial head fractures. Hand (NY), 2014, 9(1): 87-92.
11. Daneshvar P, Willing R, Pahuta M, et al. Osseous anatomy of the distal radioulnar joint: an assessment using 3-dimensional modeling and clinical implications. J Hand Surg (Am), 2016, 41(11): 1071-1079.
12. Malone PS, Shaw OG, Lees VC. Anatomic relationships of the distal and proximal radioulnar joints articulating surface areas and of the radius and ulna bone volumes-implications for biomechanical studies of the distal and proximal radioulnar joints and forearm bones. Front Bioeng Biotechnol, 2016, 4: 61.
13. Malone PS, Cooley J, Morris J, et al. The biomechanical and functional relationships of the proximal radioulnar joint, distal radioulnar joint, and interosseous ligament. J Hand Surg (Eur Vol), 2015, 40(5): 485-493.
14. Malone PS, Cooley J, Terenghi G, et al. The effect of elbow extension on the biomechanics of the osseoligamentous structures of the forearm. J Hand Surg (Am), 2015, 40(9): 1776-1784.
15. Daecke W, Martini AK, Streich NA. Kapandji-Sauvé procedure for chronic disorders of the distal radioulnar joint with special regard to the long-term results. Handchir Mikrochir Plast Chir, 2003, 35(3): 164-169.
16. Czermak C, Wittemann M, Germann G, et al. Functional results after the Kapandji-Sauvé operation for salvage of the distal radioulnar joint. Handchir Mikrochir Plast Chir, 2007, 39(6): 403-408.
17. Ross M, Thomas J, Couzens G, et al. Salvage of the unstable Sauvé-Kapandji procedure: a new technique. Tech Hand Up Extrem Surg, 2007, 11(1): 87-92.
18. Zimmermann R, Gabl M, Angermann P, et al. Long-term results after a modified Sauvé-Kapandji procedure. Report on 105 post-traumatic cases. Unfallchirurg, 2003, 106(7): 561-565.
19. 王云亭, 林朋, 史振才, 等. Sauvé-Kapandji 手術治療橈尺遠側關節脫位的療效. 中華手外科雜志, 2000, 16(3): 146-148.

Chinese Journal of Reparative and Reconstructive Surgery

Treatment of traumatic ulnar styloid impaction syndrome by Sauvé-Kapandji procedure

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