Modified Sauvé-Kapandji procedure for restoration of forearm rotation in devascularized hands

Ir J Med Sci. 2014 Dec;183(4):643-7. doi: 10.1007/s11845-014-1067-6. Epub 2014 Jan 28.

Abstract

Introduction: The purpose of this study is to evaluate the clinical outcomes in patients with forearm rotation limitation after successful wrist-level revascularization who underwent a modified Sauvé-Kapandji (S-K) procedure.

Methods: This was a retrospective review of the clinical records of nine patients (three women, six men) after successful wrist-level revascularization who underwent late restoration of forearm rotation. All patients were evaluated using a Mayo Modified Wrist Score. The mean patient age was 35 (range 19-45) years. Mean time to reconstruction was 2.5 (range 0.5-4) years.

Results: Mean postoperative pronation was 74°; mean postoperative supination was 80°. Overall results were excellent/good in seven patients, fair in one, and poor in one. No bone bridge was formed between the pseudarthrosis in any patient. Two patients had neurapraxia. Moderate pain and snapping occurred in one patient during movement at the ulnar amputation site.

Conclusion: This modification of the S-K procedure can restore rotation of the forearm after hand revascularization; as such, it provides an alternative salvage procedure.

MeSH terms

  • Adult
  • Arthrodesis
  • Bone Transplantation
  • Female
  • Forearm / physiopathology*
  • Hand / blood supply
  • Humans
  • Male
  • Middle Aged
  • Recovery of Function*
  • Retrospective Studies
  • Rotation*
  • Tenodesis
  • Wrist Joint / surgery*