Comparative Results of Resection of the Distal Ulna in Rheumatoid Arthritis and Post-Traumatic Conditions

1999 ◽  
Vol 24 (6) ◽  
pp. 667-670 ◽  
Author(s):  
K. E. FRASER ◽  
E. DIAO ◽  
C. A. PEIMER ◽  
F. S. SHERWIN
Keyword(s):  
Rheumatoid Arthritis ◽  
Pain Relief ◽  
Range Of Motion ◽  
Grip Strength ◽  
Distal Radioulnar Joint ◽  
Distal Ulna ◽  
Radioulnar Joint ◽  
Post Traumatic ◽  
Comparative Results ◽  
Trauma Group

The purpose of this study was to determine whether the results of resection of the distal ulna differed depending upon the underlying aetiology of the condition. Patients with rheumatoid arthritis were compared with patients with post-traumatic wrist complaints. Fifty resections in 40 patients (eight male, 32 female) were assessed with respect to pain, range of motion, and grip strength. Of the 23 rheumatoid wrists, 86% were pain-free following surgery; however, only 36% of the patients in the trauma group reported pain relief postoperatively. Pain relief in posttraumatic patients was more predictable when distal radioulnar joint arthrosis was identified as the sole cause of wrist pain.

DISTAL RADIOULNAR JOINT DORSAL INSTABILITY TREATED WITH DORSAL CAPSULAR RECONSTRUCTION

Hand Surgery ◽  
2004 ◽  
Vol 09 (01) ◽  
pp. 55-61 ◽  
Author(s):  
Kwok-Ho Wong ◽  
Tak-Hing Yip ◽  
Wing-Cheung Wu
Keyword(s):  
Pain Relief ◽  
Range Of Motion ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Distal Radioulnar Joint ◽  
Tendon Graft ◽  
Radioulnar Joint ◽  
Complex Injury ◽  
Triangular Fibrocartilage ◽  
Post Traumatic

Six patients with post-traumatic distal radioulnar joint dorsal instability were treated with dorsal capsular reconstruction. This new technique of reconstruction requires less extensive dissection than the previously described methods in the literature and requires no tendon graft. A total of six patients treated from 1999 to 2001 were included in this study. Two were males and four were females. The average age of patients was 30 years and all the instabilities were secondary to trauma. One of them had associated minimally displaced distal radius fracture. All patients had arthrogram and arthroscopy done before the reconstruction and had no significant triangular fibrocartilage complex injury. The surgery consisted of duplication capsulorrhaphy of the dorsal capsular structures of the distal radioulnar joint. All patients had satisfactory results after the operations in terms of pain relief, range of motion and stability.

MODIFIED MATCHED ULNAR RESECTION FOR ARTHROSIS OF DISTAL RADIOULNAR JOINT IN RHEUMATOID ARTHRITIS

Hand Surgery ◽  
2006 ◽  
Vol 11 (01n02) ◽  
pp. 15-19 ◽  
Author(s):  
K. N. Srikanth ◽  
S. A. Shahane ◽  
J. H. Stilwell
Keyword(s):  
Rheumatoid Arthritis ◽  
Retrospective Study ◽  
Pain Relief ◽  
Distal Radius ◽  
Distal Radioulnar Joint ◽  
Rheumatoid Patient ◽  
Radioulnar Joint ◽  
Ulnar Head

The pain of distal radioulnar arthrosis in rheumatoid patients is often due to disease largely confined to the radioulnar rather than the ulnocarpal articulation. This is a retrospective study of 14 patients (14 wrists) who underwent selective shaving of the radial articulation of the ulnar head leaving the ulnocarpal articulation intact. The ulnar head is reduced to the circumference of its shaft and a dorsal retinacular flap is interposed between it and the distal radius. Average age of the patients and follow-up were 63.5 years and 31 months, respectively. All patients had rheumatoid arthritis. Pain improved in 14 out of 15 wrists. Overall results were 67% good to excellent and 33% fair based on the modified Mayo's wrist score. This novel procedure for DRUJ arthrosis produces predictable pain relief in low demand rheumatoid patient.

Positive Ulnar Fovea Sign – Audit of Patient Outcomes Following Nonsurgical and Surgical Management

2019 ◽  
Vol 24 (04) ◽  
pp. 421-427
Author(s):  
Min Kai Chang ◽  
Zeus Yiwei Lim ◽  
Shian Chao Tay
Keyword(s):  
Surgical Treatment ◽  
Range Of Motion ◽  
Grip Strength ◽  
Distal Radioulnar Joint ◽  
Wrist Pain ◽  
Radioulnar Joint ◽  
Nonsurgical Management ◽  
Experienced Pain ◽  
Patient Reported ◽  
Pain Improvement

Background: Patients with ulnar-sided wrist pain and positive ulnar fovea sign are usually treated nonsurgically before surgical options are considered. However, the outcomes of nonsurgical management are unknown. Many of these patients also have unstable distal radioulnar joint, but there has been no comparison between the outcomes of these patients with stable and unstable distal radioulnar joint. The objectives of this study are to (1) determine the outcomes of nonsurgical and surgical treatment of patients with positive ulnar fovea sign, and (2) compare the outcomes of patients with stable and unstable distal radioulnar joint. Methods: A retrospective analysis of the outcomes of patients with ulnar sided wrist pain and positive fovea sign was performed from March 2009 to December 2014. Outcomes were measured based on patient-reported pain improvement, grip strength and range of motion of the affected wrist before and after treatment. A total of 100 wrists in 98 patients were reviewed. Results: 54% of wrists managed nonsurgically experienced pain improvement. 83% of wrists managed surgically experienced pain improvement. The mean grip strength increased by 2.8 kg and 2.7 kg, while the range of motion decreased by 14° and 5° after nonsurgical and surgical treatment respectively. When comparing patients with stable and unstable distal radioulnar joint, there were statistically more wrists with unstable distal radioulnar joint that experienced pain improvement after treatment. Conclusions: The study showed that there is a role for nonsurgical treatment for wrists with positive ulnar fovea sign with more than half of the patients experiencing pain improvement. We also found that positive ulnar fovea sign patients with unstable distal radioulnar joint had better pain outcomes compared to those with stable distal radioulnar joint.

scholarly journals Functional and Radiographic Outcomes of the Sauvé-Kapandji and Darrach Procedures in Rheumatoid Arthritis

2018 ◽  
Vol 11 (02) ◽  
pp. 071-079 ◽  
Author(s):  
Hannah M. Carl ◽  
Scott D. Lifchez
Keyword(s):  
Rheumatoid Arthritis ◽  
Range Of Motion ◽  
Average Length ◽  
Distal Radioulnar Joint ◽  
Functional Improvement ◽  
Single Institution ◽  
Radioulnar Joint ◽  
Radiographic Outcomes ◽  
Radiocarpal Joint

Abstract Background Deterioration of the distal radioulnar joint (DRUJ) in rheumatoid arthritis (RA) manifests as pain, weakness, and reduced range of motion. The Darrach and Sauvé-Kapandji (S-K) procedures are used when medical management fails to control these symptoms. However, there is a paucity of literature comparing the outcomes of these procedures. The purpose of this study is to compare the clinical and radiographic outcomes of the Darrach and S-K procedures in RA patients. Materials and Methods This is a retrospective, single institution cohort study of RA patients who underwent the Darrach or S-K procedure between 2008 and 2016. Ulnar translation, range of motion, and functional improvement were compared. Results Nine patients (13 wrists) underwent the Darrach procedure, and nine patients (11 wrists) underwent the S-K procedure. The average length of follow-up was 1.3 years. Pain, function, and range of motion improved in both groups. The degree of ulnar translation did not significantly change after either procedure. Conclusion Given their similar outcomes, we found no evidence that the S-K procedure is superior to the Darrach procedure or vice versa. However, when surgery is indicated for younger RA patients with DRUJ disease and ulnar translation, the S-K may be better suited to prevent radiocarpal joint dislocation.

Arthroscopic Synovectomy of the Rheumatoid Wrist

1993 ◽  
Vol 18 (1) ◽  
pp. 92-96 ◽  
Author(s):  
L. ADOLFSSON ◽  
G. NYLANDER
Keyword(s):  
Rheumatoid Arthritis ◽  
Pain Relief ◽  
Range Of Motion ◽  
Grip Strength ◽  
Surgical Procedure ◽  
Subjective Experience ◽  
Arthroscopic Synovectomy ◽  
Level Of Activity ◽  
Short Period ◽  
Good Pain Relief

18 wrists in 16 patients with synovitis due to rheumatoid arthritis were treated with arthroscopic synovectomy. The surgical procedure and the results after surgery are described. Range of motion, grip strength, subjective experience of pain and level of activity were registered pre-and post-operatively. The operations were found to give good pain relief, increased grip strength, no post-operative stiffness and a short period of rehabilitation.

Sauve-Kapandji Remains a Viable Option for Distal Radioulnar Joint Dysfunction

Hand ◽  
2020 ◽  
pp. 155894472096672
Author(s):  
Nicholas Munaretto ◽  
William Aibinder ◽  
Steven Moran ◽  
Marco Rizzo
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Distal Radioulnar Joint ◽  
High Rate ◽  
Wrist Flexion ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
Major Complications ◽  
The Mean

Introduction Dysfunction of the distal radioulnar joint (DRUJ) can be significantly debilitating. The Sauve-Kapandji (S-K) procedure can be indicated to address multiple etiologies of DRUJ dysfunction. The purpose of this study was to review our institution’s results performing the S-K procedure for DRUJ dysfunction in terms of clinical and radiographic outcomes, as well as complications and reoperations. Methods A retrospective review of S-K procedures performed at 2 institutions between 1998 and 2017 with a minimum of 1-year follow-up was performed. Preoperative and postoperative visual analog scale (VAS) pain, grip strength, and wrist range of motion were reviewed. Radiographs were reviewed for DRUJ healing, carpal translation, and radiocarpal degenerative changes. Results The cohort included 35 patients. The mean age was 51 years. The mean follow-up was 49.5 months. The postoperative range of motion was unchanged in regard to pronation, supination, and wrist extension. There was a decrease in wrist flexion from 43 degrees to 34 degrees. Successful union was noted in 100% of the wrists. There was 1 case (2.8%) of progressive ulnar translation and 4 major complications (11.3%). Conclusion The S-K procedure has several theoretical benefits compared to other procedures for DRUJ dysfunction with results of this study demonstrating excellent pain relief, improved postoperative grip strength, retained wrist pronation, supination, and extension, high rate of successful arthrodesis and low rate of major complications. Level of Evidence Level IV

Total Distal Radioulnar Joint Arthroplasty for Paediatric Post-Traumatic Distal Ulna Growth Arrest

2021 ◽  
Vol 26 (03) ◽  
pp. 467-471
Author(s):  
Brahman Sivakumar ◽  
David J. Graham ◽  
Neil F. Jones
Keyword(s):  
Distal Radius ◽  
Growth Arrest ◽  
Distal Radioulnar Joint ◽  
Joint Arthroplasty ◽  
Forearm Rotation ◽  
Distal Ulna ◽  
Radioulnar Joint ◽  
Post Traumatic Growth ◽  
Post Traumatic

Growth arrest following paediatric distal radius and ulnar fractures infrequently results in a symptomatic deformity. The distal radioulnar joint (DRUJ) plays a complex role in the motion of the wrist, allowing for forearm rotation, and acceptable reconstruction options are limited when severe deformity does occur. We present a case of symptomatic severe post traumatic growth arrest of the distal radioulnar joint which was treated by osteotomy and Scheker total distal radioulnar joint arthroplasty.

scholarly journals Functional outcomes after modified Sauve-Kapandji arthrodesis for distal radioulnar joint dysfunction

2021 ◽  
Vol 7 (2) ◽  
pp. 303
Author(s):  
Hiranya Kumar Seenappa ◽  
Karthik Narayanamurthy Mittemari ◽  
Shivaraj Nadagouda ◽  
Vamshikrishna Chand Nimmagadda
Keyword(s):  
Range Of Motion ◽  
Clinical Outcomes ◽  
Functional Assessment ◽  
Functional Outcomes ◽  
Distal Radioulnar Joint ◽  
Analog Scale ◽  
Distal Ulna ◽  
Excellent Outcome ◽  
Radioulnar Joint

<p><strong>Background: </strong>The distal radioulnar joint (DRUJ) dysfunction manifests as pain, weakness and reduced range of motion<strong>. </strong>There are various treatments for DRUJ dysfunction. Modified Sauvé-Kapandji procedure involves arthrodesis of the distal radioulnar joint combined with the creation of a pseudarthrosis of the distal ulna to maintain forearm pronation and supination, and stabilization of proximal ulnar stump. This study was performed to evaluate the clinical outcomes of modified Sauve-Kapandji procedure for patients with DRUJ dysfunction.</p><p><strong>Methods: </strong>Fourteen patients with DRUJ dysfunction were treated by modified Sauve-Kapandji procedure and followed up for 2 years post-operatively. Functional assessment was evaluated according to modified mayo wrist score (MMWS) system and severity of pain by visual analog scale. Posteroanterior and lateral radiographs were used to assess fusion.</p><p><strong>Results: </strong>There was a significant improvement in VAS of wrist pain (p&lt;0.001) and MMWS (p&lt;0.001) at 2 years follow up. Excellent outcome was reported in 64.3% (n=9) patients. Radiographic fusion was seen in all 14 cases.</p><p><strong>Conclusions: </strong>The modified<strong> </strong>Sauve-Kapandji procedure for DRUJ dysfunction is a safe and effective procedure with excellent radiological fusion and significant improvement in functional outcomes.</p><p><strong> </strong></p>

Range of Motion after the Sauvé–Kapandji and Darrach Procedures without Extensor Tendon Rupture

2020 ◽  
Author(s):  
Tomoyuki Kato ◽  
Taku Suzuki ◽  
Makoto Kameyama ◽  
Masato Okazaki ◽  
Yasushi Morisawa ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Tendon Rupture ◽  
Extensor Tendon ◽  
Distal Radioulnar Joint ◽  
Wrist Flexion ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
The Mean ◽  
Therapeutic Study ◽  
Loss Of Motion

Abstract Background Previous study demonstrated that distal radioulnar joint (DRUJ) plays a biomechanical role in extension and flexion of the wrist and suggested that fixation of the DRUJ could lead to loss of motion of the wrist. Little is known about the pre- and postoperative range of motion (ROM) after the Sauvé–Kapandji (S-K) and Darrach procedures without tendon rupture. To understand the accurate ROM of the wrist after the S-K and Darrach procedures, enrollment of patients without subcutaneous extensor tendon rupture is needed. Purpose This study aimed to investigate the pre- and postoperative ROM after the S-K and Darrach procedures without subcutaneous extensor tendon rupture in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Methods This retrospective study included 36 patients who underwent the S-K procedure and 10 patients who underwent the Darrach procedure for distal radioulnar joint disorders without extensor tendon rupture. Pre- and postoperative ROMs after the S-K and Darrach procedures were assessed 1 year after the surgery. Results In the S-K procedure, the mean postoperative ROM of the wrist flexion (40 degrees) was significantly lower than the mean preoperative ROM (49 degrees). In wrist extension, there were no significant differences between the mean preoperative ROM (51 degrees) and postoperative ROM (51 degrees). In the Darrach procedure, the mean postoperative ROM of the wrist flexion and extension increased compared with the mean preoperative ROM; however, there were no significant differences. Conclusion In the S-K procedure, preoperative ROM of the wrist flexion decreased postoperatively. This study provides information about the accurate ROM after the S-K and Darrach procedures. Level of Evidence This is a Level IV, therapeutic study.

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