“Quadrangular-construct” modification of Sauve-Kapandji procedure

BACKGROUND: Subluxation of ulna in distal radioulnar joint disorders causes pain on motion, loss of grip strength, and a restriction of forearm rotation. Several procedures have been described to salvage DRUJ disorders including the Darrach procedure, the matched distal ulnar resection, the hemiresection interposition arthroplasty (Bowers procedure) and the Sauve-Kapandji (S-K) procedure. All these procedures are associated with either loss of grip, pain over proximal ulnar stump or instability. We describe our modification of S-K procedure with good functional outcome. MATERIALS AND METHODS: Twenty patients, 12 male and 8 female, underwent S-K procedure, with our modification, were included in this study. Patients were evaluated preoperatively, postoperatively, and on followup visits using Modified Mayo Wrist Score and wrist radiographs. Average followup period was 34.55 months (range 24-64 months). RESULTS: Excellent results were found in one patient, good in 15 patients, and fair in four patients. Mean Modified Mayo Wrist Score improved from 32 to 79.75, which was statistically significant. CONCLUSIONS: Our modification of S-K procedure provides good functional outcome with stable ulnar stump and without significant procedure-related complications.