Purpose
The use of a spherical ulnar head prosthesis (UHP) for the treatment of symptomatic
radioulnar convergence after Sauvé-Kapandji (SK) procedure has shown promising results
in the short term. This study aims to evaluate the midterm outcome of the original
cohort of patients treated with this technique.
Methods
Seventeen patients with unstable ulnar stumps confirmed both clinically and radiographically
were studied. The etiology for the initial SK procedure included posttraumatic distal
radioulnar joint (DRUJ) incongruity, primary DRUJ arthrosis, and dysplastic DRUJ.
Fourteen of the 17 patients had a minimum of 2, and a maximum of 6, operations prior
to having a spherical UHP. All patients suffered from severe pain with difficulty
in performing work and daily activities. Ceramic UHP was used for all patients, except
2 in whom a cobalt chrome head was used.
Results
The average follow-up was 6 years (range, 4–17 years). A marked reduction in pain
was observed with 11 patients reporting that they remained pain free. The range of
motion of the wrist and power grip was maintained and showed a statistically significant
improvement at the late follow-up. The Disabilities of the Arm, Shoulder, and Hand
score also significantly improved from 77 to 41. There were no signs of prosthetic
loosening at the midterm follow-up. The 2 patients with cobalt chrome prostheses had
pain and osteolysis requiring revision to total DRUJ prosthesis. Two patients with
dorsal prosthetic subluxation were successfully treated with distal radial osteotomy.
Conclusions
The midterm results of ceramic spherical UHP for failed SK procedures in this small
patient series are encouraging.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: June 19, 2018
Accepted:
May 1,
2018
Received:
August 21,
2017
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2019 by the American Society for Surgery of the Hand. All rights reserved.
