Arthroscopic Ulnar Head Resection and Sauvé-Kapandji

Abstract

Osteoarthritis of distal radioulnar joint (DRUJ) is a pathological condition that results in a painful wrist with limitation of the pronosupination and grip strength. Various surgical procedures have been described to treat this disabling condition, which include total resection of the ulnar head (Darrach procedure) [4], partial resection with interposition arthroplasty (Bowers and Watson technique) [2, 19], arthrodesis of the DRUJ with ulnar resection osteotomy proximal to the arthrodesis (Sauvé-Kapandji procedure) [15], and the ulnar head prosthesis [18]. The Darrach, Bowers, Watson, and Sauvé-Kapandji (S-K) procedures have become popular treatments for both primary and secondary arthritis of DRUJ and are currently well accepted in all the world with some criticism [17]. These techniques used for restoration of pronation and supination of the forearm are considered salvage procedures. The Darrach, Bowers, and Watson procedures are less demanding surgical techniques and more simple than the S-K procedure. The S-K procedure is considered advantageous over ulnar head resection as the essential ulnar supports of the wrist; i.e. the ulnar head, the distal radioulnar ligaments and the ulnocarpal ligaments are well preserved [17]. Another advantage of the S-K procedure is the shorter postoperative immobilization, which is an additional benefit for the patient.