Association between position of the fixed ulnar head and carpal translocation after the Sauvé-Kapandji procedure in patients with rheumatoid arthritis

Mod Rheumatol. 2016 Sep;26(5):702-7. doi: 10.3109/14397595.2016.1145315. Epub 2016 Mar 11.

Abstract

Objective: The Sauvé-Kapandji procedure is a common surgical procedure for rheumatoid wrist, which involves fixing dissected ulnar head to the distal radius in order to provide "bony support" to the carpus. The purpose of this study was to investigate whether the position of the fixed ulnar head was associated with postsurgical carpus translocation.

Methods: We retrospectively reviewed radiographs of 40 patients who underwent the Sauvé-Kapandji procedure and were subsequently followed up for over two years. The association between the fixed ulnar head position and postsurgical carpus translocation was statistically analysed with a confidence interval of 95% (p < 0.05).

Results: Multiple regression analysis suggested that the radial inclination of the fixed ulnar head, the absence of increases in ulnar variance, and wide "bony support" were significantly associated with less postsurgical carpal translocation.

Conclusion: Our study indicated that good concordance between the "bony support" and the carpus might be important in reducing postsurgical carpus translocation.

Keywords: Carpus; Rheumatoid arthritis; Sauvé–Kapandji procedure; Translocation; Wrist arthroplasty.

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / diagnostic imaging
  • Arthritis, Rheumatoid / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Orthopedic Procedures / methods
  • Radiography
  • Radius / diagnostic imaging
  • Radius / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Ulna / diagnostic imaging
  • Ulna / surgery*
  • Wrist Joint / diagnostic imaging
  • Wrist Joint / surgery*