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Darrach vs. Sauve-Kapandji: A Comprehensive Meta-Analysis of Surgical Outcomes in Distal Radioulnar Joint (DRUJ) Dysfunction

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Abstract

Introduction

Optimal treatment of chronic distal radioulnar joint (DRUJ) arthritis and instability remains unresolved in the literature. Specifically, no systematic comparison of two common options, Sauve-Kapandji (SK) and Darrach's, is available.

Methods

A meta-analysis was performed utilizing the PUBMED and EMBASE databases and yielded a total of 47 available studies. Objective outcomes, such as wrist range of motion (ROM), forearm ROM, grip strength, and subjective outcomes, including pain and rate of return to work, were recorded. Statistical analysis was done using t test and chi-square test.

Results

For both the SK and Darrach’s procedures, forearm ROM was significantly better postoperatively in both pronation (p = 0.0001 for both groups) and supination (p = 0.0001 for both groups). Wrist flexion decreased in the SK group (p = 0.0007), but no difference was found for wrist extension (p = 0.09). The Darrach's group showed a significance improvement in wrist extension (p = 0.0001). Grip strength was improved in the SK group (p < 0.0001), but not in the Darrach's group (p = 0.7831). No difference existed between the SK and Darrach's groups in proportion of patients who were pain-free. The SK group had higher numbers of patients return to work (p = 0.0057). There was not enough data from the studies to make any meaningful analysis in term of treatment failure and complications.

Conclusions

Overall, both the SK and Darrach's procedures helped improve pain, wrist ROM, and forearm ROM in patient with chronic DRUJ disorders. The SK procedure can have advantages over the Darrach's procedures in terms of grip strength and rate of return to work.

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References

  1. Chidgey, L. K. (1995). The distal radioulnar joint: Problems and solutions. Journal of American Academy of Orthopaedic Surgeons, 3(2), 95–109. https://doi.org/10.5435/00124635-199503000-00005

    Article  CAS  Google Scholar 

  2. Jochen-Frederick, H., Pouyan, Y., Khosrow, B. A., et al. (2016). Long-term functional outcome and patient satisfaction after ulnar head resection. Journal of Plastic, Reconstructive & Aesthetic Surgery, 69(10), 1417–1423.

    Article  Google Scholar 

  3. Darrach, W. (1992). Partial excision of lower shaft of ulna for deformity following colles’s fracture. 1913. Clinical Orthopaedics and Related Research, 275, 3–4.

    Article  Google Scholar 

  4. Carl, H. M., & Lifchez, S. D. (2019). Functional and radiographic outcomes of the sauvé-kapandji and darrach procedures in rheumatoid arthritis. Journal of Hand and Microsurgery, 11(2), 71–79. https://doi.org/10.1055/s-0038-1670926

    Article  PubMed  Google Scholar 

  5. Minami, A., Iwasaki, N., Ishikawa, J., Suenaga, N., Yasuda, K., & Kato, H. (2005). Treatments of osteoarthritis of the distal radioulnar joint: Long-term results of three procedures. Hand Surgery, 10(2–3), 243–248.

    Article  PubMed  Google Scholar 

  6. Ikeda, M., Kawabata, A., Suzuki, K., Toyama, M., & Egi, T. (2018). Outcome of the sauvé-kapandji procedure for distal radioulnar joint disorder with rheumatoid arthritis or osteoarthritis: Results of one-year follow-up. Modern Rheumatology, 28(3), 490–494. https://doi.org/10.1080/14397595.2017.1366005

    Article  PubMed  Google Scholar 

  7. Kawabata, A., Egi, T., Hashimoto, H., Masada, K., & Saito, S. (2010). A comparative study of the modified sauvé-kapandji procedure for rheumatoid wrist with and without stabilization of the proximal ulnar stump. Journal of Hand Surgery (European Volume), 35(8), 659–663. https://doi.org/10.1177/1753193410367599

    Article  CAS  PubMed  Google Scholar 

  8. Minami, A., Kamiya, Y., Tojo, Y., Harmon, S. M., & Suda, K. (2018). Modified sauvé-kapandji procedure for the distal radioulnar joint disorders of osteoarthritis and rheumatoid arthritis. Journal of Orthopaedic Science, 23(3), 516–520.

    Article  PubMed  Google Scholar 

  9. Giberson-Chen, C. C., Leland, H. A., Benavent, K. A., Harper, C. M., Earp, B. E., & Rozental, T. D. (2020). Functional outcomes after sauve-kapandji arthrodesis. Journal of Hand Surgery (American Volume), 45(5), 408–416.

    Article  Google Scholar 

  10. Abe, A., & IshikawaKim, H. (2019). Ulnar stump stabilization using the flexor carpi ulnaris tendon for the rheumatoid wrist. The Journal of Hand Surgery (Asian-Pacific Volume), 24(4), 447–451. https://doi.org/10.1142/S2424835519500577

    Article  PubMed  Google Scholar 

  11. Nakagawa, N., Abe, S., Kimura, H., Imura, S., Nishibayashi, Y., & Yoshiya, S. (2003). Comparison of the sauvé-kapandji procedure and the darrach procedure for the treatment of rheumatoid wrists. Modern Rheumatology, 13(3), 239–242. https://doi.org/10.3109/s10165-003-0229-6

    Article  PubMed  Google Scholar 

  12. Shearman, C. P. (1988). The long-term outcome following darrach’s procedure for complications of fractures of the distal radius. Injury, 19(5), 318–320.

    Article  CAS  PubMed  Google Scholar 

  13. Grawe, B., Heincelman, C., & Stern, P. (2012). Functional results of the darrach procedure: A long-term outcome study. Journal of Hand Surgery (American Volume), 37(12), 2475–2482.

    Article  Google Scholar 

  14. McKee, M. D., & Richards, R. R. (1996). Dynamic radio-ulnar convergence after the darrach procedure. Journal of Bone and Joint Surgery. British Volume, 78(3), 413–418.

    Article  CAS  PubMed  Google Scholar 

  15. Kobayashi, A., Futami, T., Tadano, I., Fujita, M., Watanabe, T., & Moriguchi, T. (2005). Radiographic comparative evaluation of the sauve-kapandji procedure and the darrach procedure for rheumatoid wrist reconstruction. Modern Rheumatology, 15(3), 187–190. https://doi.org/10.1007/s10165-005-0396-8

    Article  PubMed  Google Scholar 

  16. Ota, N., Nakamura, T., Iwamoto, T., Sato, K., & Toyama, Y. (2013). Radiographic parameter analysis on modified sauvé-kapandji procedure. Journal of Wrist Surgery, 2(1), 19–26. https://doi.org/10.1055/s-0032-1333061

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Hand and Upper Extremity Center, Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Suite 3200, Columbus, OH, 43212, USA

    Minh H. Nguyen, Andrew L. O’Brien & Sonu A. Jain

  2. The Ohio State University College of Medicine, Columbus, USA

    Nicholas Lipari

  3. Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, USA

    Richard Samade

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  1. Minh H. Nguyen
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Correspondence to Sonu A. Jain.

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Nguyen, M.H., Lipari, N., O’Brien, A.L. et al. Darrach vs. Sauve-Kapandji: A Comprehensive Meta-Analysis of Surgical Outcomes in Distal Radioulnar Joint (DRUJ) Dysfunction. JOIO 57, 565–570 (2023). https://doi.org/10.1007/s43465-023-00826-5

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  • DOI: https://doi.org/10.1007/s43465-023-00826-5

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