Sauvé-Kapandji procedure

Indications

The Sauvé-Kapandji procedure consists of fusion of the distal radioulnar joint (DRUJ) and resection of a short segment of ulna proximal to the joint to preserve forearm motion. It eliminates the painful articulation between the ulna and sigmoid notch and maintains normal anatomic alignment of the wrist. When intact, triangular fibrocartilage complex (TFCC) function is preserved.
The Sauvé-Kapandji procedure is indicated in patients with DRUJ dysfunction who are at risk for ulnar carpal translation from inflammatory arthritis or traumatic radiocarpal ligament injuries.
Although outcomes are equivalent compared with distal ulna resection, the Sauvé-Kapandji procedure is preferred in young and high-demand patients.
Integrity of the TFCC is not a prerequisite for this procedure but may be advantageous.

Insufficient bone stock at the distal ulna or a grossly deformed ulna head that could cause tendon irritation is a contraindication.
Positive ulnar variance is suitable for the shelf arthroplasty procedure as described.
Prior radial head resection, especially with a history of an Essex-Lopresti injury with disruption of the interosseous membrane that can further destabilize the forearm axis.

See Clinical Examination in Chapter 49 Distal Ulna Resection (Darrach Procedure).

See Imaging in Chapter 49 .

See Surgical Anatomy in Chapter 49 .

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