Introduction and Early Outcomes of Intraosseous Distal Radioulnar Joint Prosthesis: A Pilot Study and a Technique on a New Design of the Sauvé-Kapandji Procedure

Document Type : RESEARCH PAPER

Authors

Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background: Different surgical procedures have been proposed for the treatment of Distal Radioulnar Joint (DRUJ)
arthrosis and other conditions. This study aimed to introduce a new design of DRUJ prosthesis based on the Sauvé-
Kapandji procedure followed by the evaluation of its short-term results. Darrach and Sauvé-Kapandji techniques are
two well-known salvage procedures. Various implant designs have been proposed for DRUJ substitution to avoid the
disadvantages of these procedures.
Methods: Before and after the insertion of the intraosseous DRUJ prosthesis in five patients, indices, such as the
range of motion, as well as grip and pinch strengths were measured and recorded. Moreover, the patients were asked
to complete three questionnaires (i.e., Quick-Disabilities of the Arm, Shoulder and Hand; Visual Analogue Scale-Pain;
and Patient-Rated Wrist Evaluation).
Results: The patients were followed up for 27.6 months. It is worth mentioning that all patients completed the followup
period with no complication, except for one case who came with dislocation secondary to forearm malunion and
proximal forearm impingement. According to the results, there were improvements in all indices, compared to preoperation.
Conclusion: The intraosseous distal radioulnar prosthesis can be an alternative option for the replacement of DRUJ.
Level of evidence: IV

Keywords

References

1. Berger RA, Cooney WP. Use of an ulnar head
endoprosthesis for treatment of an unstable distal 
ulnar resection: review of mechanics, indications, and
surgical technique. Hand clinics. 2005; 21(4):603-20.
2. Bell MJ, Hill RJ, McMurtry RY. Ulnar impingement
syndrome. The Journal of bone and joint surgery.
British volume. 1985; 67(1):126-9.
3. DARRACH W. Partial Excision of Lower Shaft of Ulna
for Deformity Following Colles’s Fracture. Clinical
Orthopaedics and Related Research (1976-2007).
1992; 275:3-4.
4. Bowers WH. Distal radioulnar joint arthroplasty: the
hemiresection-interposition technique. Journal of
Hand Surgery. 1985; 10(2):169-78.
5. Kapandji IA. The Kapandji-Sauvé operation. Its
techniques and indications in non-rheumatoid
diseases. Annales de chirurgie de la main: organe
officiel des societes de chirurgie de la main. 1986;
5(3):181-93.
6. Field J, Majkowski RJ, Leslie IJ. Poor results of Darrach’s
procedure after wrist injuries. The Journal of bone
and joint surgery. British volume. 1993; 75(1):53-7.
7. Bieber EJ, Linscheid RL, Dobyns JH, Beckenbaugh
RD. Failed distal ulna resections. The Journal of hand
surgery. 1988; 13(2):193-200.
8. Minami A, Iwasaki N, Ishikawa JI, Suenaga N, Yasuda
K, Kato H. Treatments of osteoarthritis of the
distal radioulnar joint: long-term results of three
procedures. Hand Surgery. 2005; 10(02n03):243-8.
9. Hagert CG. The distal radioulnar joint in relation to
the whole forearm. Clinical orthopaedics and related
research. 1992 (275):56-64.
10. Lees VC, Scheker LR. The radiological demonstration
of dynamic ulnar impingement. Journal of Hand
Surgery. 1997; 22(4):448-50.
11. Sanders RA, Frederick HA, Hontas RB. The Sauvé-
Kapandji procedure: a salvage operation for the distal
radioulnar joint. The Journal of hand surgery. 1991;
16(6):1125-9.
12. Sauerbier M, Hahn ME, Fujita M, Neale PG, Berglund
LJ, Berger RA. Analysis of dynamic distal radioulnar
convergence after ulnar head resection and
endoprosthesis implantation. The Journal of hand
surgery. 2002; 27(3):425-34.
13. van Schoonhoven J, Fernandez DL, Bowers WH,
Herbert TJ. Salvage of failed resection arthroplasties
of the distal radioulnar joint using a new ulnar
head prosthesis. The Journal of hand surgery. 2000;
25(3):438-46.
14. Gordon KD, Dunning CE, Johnson JA, King GJ.
Kinematics of ulnar head arthroplasty. Journal of
hand surgery. 2003; 28(6):551-8.
15. Schuurman AH, Teunis T. A new total distal radioulnar
joint prosthesis: functional outcome. The Journal of
hand surgery. 2010; 35(10):1614-9.
16. Gummesson C, Ward MM, Atroshi I. The shortened
disabilities of the arm, shoulder and hand
questionnaire (Quick DASH): validity and reliability
based on responses within the full-length DASH. BMC 
musculoskeletal disorders. 2006; 7(1):44.
17. Ebrahimzadeh MH, Moradi A, Vahedi E, Kachooei AR,
Birjandinejad A. Validity and reliability of the Persian
version of shortened disabilities of the arm, shoulder
and hand questionnaire (quick-DASH). International
journal of preventive medicine. 2015; 6.
18. da Silva Rodrigues EK, Fonseca MD, MacDermid JC.
Brazilian version of the Patient Rated Wrist Evaluation
(PRWE-BR): Cross-cultural adaptation, internal
consistency, test-retest reliability and construct
validity. Journal of Hand Therapy. 2015; 28(1):69-76.
19. Hassankhani GG, Moradi A, Vahedi E, Hoseinian SH,
Jahani Z, Rahmani M, et al. Psychometric Properties
of the Persian Version of the Patient Rated Wris t
Evaluation. Archives of Bone and Joint Surgery. 2017;
5(4):243.
20. Collins SL, Moore RA, McQuay HJ. The visual analogue
pain intensity scale: what is moderate pain in
millimetres? Pain. 1997; 72(1-2):95-7.
21. contributors W. Grip strength: Wikipedia, The Free
Encyclopedia.; [updated 23 July 2017 09:37 UTC].
Available from: https://en.wikipedia.org/w/index.
php?title=Grip_strength&oldid=791924225.
22. SINGH DAP. Normal Wrist Motion. Available from:
http://boneandspine.com/normal-wrist-motion/.
23. Sauerbier M, Fujita M, Hahn ME, Neale PG, Berger
RA. The dynamic radioulnar convergence of the
Darrach procedure and the ulnar head hemiresection
interposition arthroplasty: a biomechanical study.
Journal of hand surgery. 2002; 27(4):307-16.
24. Masaoka S, Longsworth SH, Werner FW, Short WH,
Green JK. Biomechanical analysis of two ulnar head
prostheses. The Journal of hand surgery. 2002;
27(5):845-53.
25. Conaway DA, Kuhl TL, Adams BD. Comparison of the
native ulnar head and a partial ulnar head resurfacing
implant. The Journal of hand surgery. 2009;
34(6):1056-62.
26. van Schoonhoven J, Mühldorfer-Fodor M, Fernandez
DL, Herbert TJ. Salvage of failed resection
arthroplasties of the distal radioulnar joint using an
ulnar head prosthesis: long-term results. The Journal
of hand surgery. 2012; 37(7):1372-80.
27. Willis AA, Berger RA, Cooney III WP. Arthroplasty of
the distal radioulnar joint using a new ulnar head
endoprosthesis: preliminary report. The Journal of
hand surgery. 2007; 32(2):177-89.
28. Axelsson P, Sollerman C. Constrained implant
arthroplasty as a secondary procedure at the distal
radioulnar joint: early outcomes. The Journal of hand
surgery. 2013; 38(6):1111-8.
29. Calcagni M, Giesen T. Distal radioulnar joint
arthroplasty with implants: a systematic review.
EFORT open reviews. 2016; 1(5):191-6.
The Archives of Bone and Joint Surgery
Volume 8, Issue 6
November and December 2020
Pages 703-709

Files

History

  • Receive Date: 21 November 2019
  • Revise Date: 04 January 2020
  • Accept Date: 14 January 2020

Share

How to cite

Statistics