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.	陈君蓉, 但倩, 张滔, 等. X线平片、CT、MRI对尺骨撞击综合征的对照研究. 华西医学, 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, 蔡贤华, 王庆, 等. 桡尺韧带关节内重建术治疗桡尺远侧关节陈旧性脱位. 中国修复重建外科杂志, 2014, 28(2): 205-208.
6.	Reissner L, Böttger 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.	唐诗添, 刘刚, 张定伟, 等. 带血管蒂头状骨瓣移位治疗终末期月骨缺血性坏死的远期疗效. 中国修复重建外科杂志, 2014, 28(8): 925-928.
9.	陈振兵, 洪光祥, 王发斌. 上肢功能评定表. 中国修复重建外科杂志, 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 手术治疗桡尺远侧关节脱位的疗效. 中华手外科杂志, 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. 陈君蓉, 但倩, 张滔, 等. X线平片、CT、MRI对尺骨撞击综合征的对照研究. 华西医学, 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, 蔡贤华, 王庆, 等. 桡尺韧带关节内重建术治疗桡尺远侧关节陈旧性脱位. 中国修复重建外科杂志, 2014, 28(2): 205-208.
6. Reissner L, Böttger 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. 唐诗添, 刘刚, 张定伟, 等. 带血管蒂头状骨瓣移位治疗终末期月骨缺血性坏死的远期疗效. 中国修复重建外科杂志, 2014, 28(8): 925-928.
9. 陈振兵, 洪光祥, 王发斌. 上肢功能评定表. 中国修复重建外科杂志, 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 手术治疗桡尺远侧关节脱位的疗效. 中华手外科杂志, 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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