The Sauvé-Kapandji procedure for post-traumatic distal radioulnar arthrosis: long-term results and analysis of risks factors for revision surgery. Deneuville, M., Germon, C., Nachef, N. S., Chazard, E., Chantelot, C., & Saab, M. Orthopaedics & traumatology, surgery & research: OTSR, January, 2023.
doi  abstract   bibtex   
INTRODUCTION: The Sauvé Kapandji (SKp) procedure is a frequently used surgery for the management of post-traumatic sequelae of the distal radioulnar joint (DRU). Series evaluating long-term outcomes and the risk of complications are rare. The main objective was to describe the long-term clinical and radiographic results after SKp performed in a post-traumatic context. The secondary objectives were to identify postoperative complications, surgical revisions, and their risk factors for occurrence. Our hypothesis was that although SKp confers good clinical results, identifiable risk factors for complications exist. PATIENTS AND METHODS: This monocentric retrospective study included all patients for whom an SKp was performed in a post-traumatic context from 2008 to 2018. Pain, satisfaction, range of motion and pre- and postoperative radiographic measurements were recorded. All complications were sought and described, as well as surgical revisions. Several variables were analyzed to identify risk factors for revision surgery after SKp: age, sex, initial traumatic mechanism, initial non-surgical or surgical treatment and type of surgery, time until revision surgery with SKp after the initial trauma. RESULTS: Thirty-seven patients were included. At a median follow-up of 9.5 years (min 7.3 - max 11.5), 22 patients (60%) had a VAS of 0. Range of motion was significantly improved for all the patients (p\textless0.001). Seventeen (46%) patients had a complication, including 5 (13.4%) cases of ossification, 4 (10.8%) cases of discomfort related to the hardware and 4 (10.8%) painful instability at the proximal ulnar stump. Thirteen (35%) patients required revision surgery. Two risk factors for revision surgery after SKp were found: time period between initial treatment and SKp of less than 7.2 months and an age of less than 53.5 years; the combination of the two factors having a sensitivity of 97.5 and a specificity of 56.7. CONCLUSION: SKp in a post-traumatic context significantly improved range of motion and allowed pain control at long follow-up. Revision surgery seemed more frequent in patients under 53.5 years of age and when SKp was performed less than 7.2 months after the initial trauma. LEVEL OF EVIDENCE: IV, retrospective study.
@article{deneuville_sauve-kapandji_2023,
	title = {The {Sauvé}-{Kapandji} procedure for post-traumatic distal radioulnar arthrosis: long-term results and analysis of risks factors for revision surgery},
	issn = {1877-0568},
	shorttitle = {The {Sauvé}-{Kapandji} procedure for post-traumatic distal radioulnar arthrosis},
	doi = {10.1016/j.otsr.2023.103562},
	abstract = {INTRODUCTION: The Sauvé Kapandji (SKp) procedure is a frequently used surgery for the management of post-traumatic sequelae of the distal radioulnar joint (DRU). Series evaluating long-term outcomes and the risk of complications are rare. The main objective was to describe the long-term clinical and radiographic results after SKp performed in a post-traumatic context. The secondary objectives were to identify postoperative complications, surgical revisions, and their risk factors for occurrence. Our hypothesis was that although SKp confers good clinical results, identifiable risk factors for complications exist.
PATIENTS AND METHODS: This monocentric retrospective study included all patients for whom an SKp was performed in a post-traumatic context from 2008 to 2018. Pain, satisfaction, range of motion and pre- and postoperative radiographic measurements were recorded. All complications were sought and described, as well as surgical revisions. Several variables were analyzed to identify risk factors for revision surgery after SKp: age, sex, initial traumatic mechanism, initial non-surgical or surgical treatment and type of surgery, time until revision surgery with SKp after the initial trauma.
RESULTS: Thirty-seven patients were included. At a median follow-up of 9.5 years (min 7.3 - max 11.5), 22 patients (60\%) had a VAS of 0. Range of motion was significantly improved for all the patients (p{\textless}0.001). Seventeen (46\%) patients had a complication, including 5 (13.4\%) cases of ossification, 4 (10.8\%) cases of discomfort related to the hardware and 4 (10.8\%) painful instability at the proximal ulnar stump. Thirteen (35\%) patients required revision surgery. Two risk factors for revision surgery after SKp were found: time period between initial treatment and SKp of less than 7.2 months and an age of less than 53.5 years; the combination of the two factors having a sensitivity of 97.5 and a specificity of 56.7.
CONCLUSION: SKp in a post-traumatic context significantly improved range of motion and allowed pain control at long follow-up. Revision surgery seemed more frequent in patients under 53.5 years of age and when SKp was performed less than 7.2 months after the initial trauma.
LEVEL OF EVIDENCE: IV, retrospective study.},
	language = {eng},
	journal = {Orthopaedics \& traumatology, surgery \& research: OTSR},
	author = {Deneuville, Marine and Germon, Charlotte and Nachef, Nadine Sturbois and Chazard, Emmanuel and Chantelot, Christophe and Saab, Marc},
	month = jan,
	year = {2023},
	pmid = {36702297},
	keywords = {Distal radioulnar osteoarthritis, Radioulnar joint, Sauve Kapandji procedure, Wrist},
	pages = {103562},
}
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