sauve kapanji
TRANSCRIPT
Dr. med. Camillo MüllerCentre de la MainCHUV, Lausanne
Sauvé-Kapandji vs Darrach
Sauvé-Kapandji vs Darrach
23/08/2015 44• Bibliographie
INTRODUCTION
introduction
anatomy
biomechanic
arthrosis
comparison
Faut-il préférer l’intervention de Sauvé-Kapandji à celle de Darrach en cas de pathologie de l’articulation radio-ulniare distale?
23/08/2015 55• Bibliographie
INTRODUCTION
introduction
anatomy
biomechanic
arthrosis
comparison
Darrach
Sauve-Kapandji
23/08/2015 66• Bibliographie
INTRODUCTION
introduction
anatomy
biomechanic
arthrosis
comparison
23/08/2015 77• Bibliographie
ANATOMY
introduction
anatomy
biomechanic
arthrosis
comparison
http://link.springer.com/article/10.1007/s00113-012-2178-z
23/08/2015 88• Bibliographie
BIOMECHANIC
introduction
anatomy
biomechanic
arthrosis
comparison
https://en.wikipedia.org/wiki/Diva
23/08/2015 99• Bibliographie
BIOMECHANIC
introduction
anatomy
biomechanic
arthrosis
comparison
J Der Unfallchirurg V 115 N 7R 10.1007/s00113-012-2178-z Die Behandlung der Arthrose des distalen Radioulnargelenks http://dx.doi.org/10.1007/s00113-012-2178-z
23/08/2015 1010• Bibliographie
BIOMECHANIC
introduction
anatomy
biomechanic
arthrosis
comparison
J Der Unfallchirurg V 115 N 7R 10.1007/s00113-012-2178-z Die Behandlung der Arthrose des distalen Radioulnargelenks http://dx.doi.org/10.1007/s00113-012-2178-z
23/08/2015 1111• Bibliographie
ARTHROSIS
introduction
anatomy
biomechanic
arthrosis
comparison
J Der Unfallchirurg V 115 N 7R 10.1007/s00113-012-2178-z Die Behandlung der Arthrose des distalen Radioulnargelenks http://dx.doi.org/10.1007/s00113-012-2178-z
23/08/2015 1212• Bibliographie
ARTHROSIS
introduction
anatomy
biomechanic
arthrosis
comparison
• Dégénérative / Posttraumatique / Congénital
• Plaintes:
• dlrs: dorsales, charge transversal, pro-supination
• observation: malposition, tuméfaction ulnaire
• palpation: dlrs: dorsales DRUJ
• motricité: instabilité DRUJ
J Der Unfallchirurg V 115 N 7R 10.1007/s00113-012-2178-z Die Behandlung der Arthrose des distalen Radioulnargelenks http://dx.doi.org/10.1007/s00113-012-2178-z
23/08/2015 1313• Bibliographie
ARTHROSIS
introduction
anatomy
biomechanic
arthrosis
comparison
• Rx: prodrome: DRUJ proximal: ostéophytes
• CT- axial
J Der Unfallchirurg V 115 N 7R 10.1007/s00113-012-2178-z Die Behandlung der Arthrose des distalen Radioulnargelenks http://dx.doi.org/10.1007/s00113-012-2178-z
23/08/2015 1414• Bibliographie
COMPARISON
introduction
anatomy
biomechanic
arthrosis
comparison
• Options thérapeutique:• Darrach• Bowers (hémi-resection)• Watson (hémi-resection)• Sauvé-Kapandji (arthrodèse RU)• Prothèse tête ulnaire
J Der Unfallchirurg V 115 N 7R 10.1007/s00113-012-2178-z Die Behandlung der Arthrose des distalen Radioulnargelenks http://dx.doi.org/10.1007/s00113-012-2178-z
23/08/2015 1515• Bibliographie
COMPARISON
introduction
anatomy
biomechanic
arthrosis
comparison
• Options thérapeutique:• Darrach• Bowers (hémi-resection)• Watson (hémi-resection)• Sauvé-Kapandji (arthrodèse RU)• Prothèse tête ulnaire
J Der Unfallchirurg V 115 N 7R 10.1007/s00113-012-2178-z Die Behandlung der Arthrose des distalen Radioulnargelenks http://dx.doi.org/10.1007/s00113-012-2178-z
23/08/2015 1616• Bibliographie
COMPARISON I
introduction
anatomy
biomechanic
arthrosis
comparison
24 specimens 1 control group (6)2 ulnar-shortening (6)3 Sauvé-Kapandji (6)4 Darrach (6)
Ulnar impaction syndrome with different operative methods: a comparative biomechanical study.Yu YD, Wu T, Tian FT, Shang YT, Yu XF, Bai YB, Han CL.Int J Clin Exp Med. 2015 Apr 15;8(4):5715-22. eCollection 2015.PMID: 26131156
23/08/2015 1717• Bibliographie
COMPARISON I
introduction
anatomy
biomechanic
arthrosis
comparison
24 specimens 1 control group (6)2 ulnar-shortening (6)3 Sauvé-Kapandji (6)4 Darrach (6)
Ulnar impaction syndrome with different operative methods: a comparative biomechanical study.Yu YD, Wu T, Tian FT, Shang YT, Yu XF, Bai YB, Han CL.Int J Clin Exp Med. 2015 Apr 15;8(4):5715-22. eCollection 2015.PMID: 26131156
23/08/2015 1818• Bibliographie
COMPARISON I
introduction
anatomy
biomechanic
arthrosis
comparison
pressure sensitive film Ulnar impaction syndrome with different operative methods: a comparative biomechanical study.Yu YD, Wu T, Tian FT, Shang YT, Yu XF, Bai YB, Han CL.Int J Clin Exp Med. 2015 Apr 15;8(4):5715-22. eCollection 2015.PMID: 26131156
23/08/2015 1919• Bibliographie
COMPARISON I
introduction
anatomy
biomechanic
arthrosis
comparison
pressure sensitive film Ulnar impaction syndrome with different operative methods: a comparative biomechanical study.Yu YD, Wu T, Tian FT, Shang YT, Yu XF, Bai YB, Han CL.Int J Clin Exp Med. 2015 Apr 15;8(4):5715-22. eCollection 2015.PMID: 26131156
23/08/2015 2020• Bibliographie
COMPARISON I
introduction
anatomy
biomechanic
arthrosis
comparison
23/08/2015 2121• Bibliographie
COMPARISON I
introduction
anatomy
biomechanic
arthrosis
comparison
Conclusions: the ulnar-shortening superior toSauvé-Kapandji and Darrach procedure
Ulnar impaction syndrome with different operative methods: a comparative biomechanical study.Yu YD, Wu T, Tian FT, Shang YT, Yu XF, Bai YB, Han CL.Int J Clin Exp Med. 2015 Apr 15;8(4):5715-22. eCollection 2015.PMID: 26131156
23/08/2015 2222• Bibliographie
COMPARISON II
introduction
anatomy
biomechanic
arthrosis
comparison
• retrospective study• Darrach vs Sauve–Kapandji procedure
• Twelve patients in the Sauve–Kapandji group Twenty-one of the Darrach group
The Sauve-Kapandji procedure and the Darrach procedure for distal radio-ulnar joint dysfunction after Colles' fracture. George MS, Kiefhaber TR, Stern PJ.J Hand Surg Br. 2004 Dec;29(6):608-13. PMID: 15542225
23/08/2015 2323• Bibliographie
COMPARISON II
introduction
anatomy
biomechanic
arthrosis
comparison
The Sauve-Kapandji procedure and the Darrach procedure for distal radio-ulnar joint dysfunction after Colles' fracture. George MS, Kiefhaber TR, Stern PJ.J Hand Surg Br. 2004 Dec;29(6):608-13. PMID: 15542225
23/08/2015 2424• Bibliographie
COMPARISON II
introduction
anatomy
biomechanic
arthrosis
comparison
The Sauve-Kapandji procedure and the Darrach procedure for distal radio-ulnar joint dysfunction after Colles' fracture. George MS, Kiefhaber TR, Stern PJ.J Hand Surg Br. 2004 Dec;29(6):608-13. PMID: 15542225
Grip strength lower in the Darrach than in the Sauve–Kapandji not a statistically significant difference
There were no significant differences in the Modified Mayo Wrist Scores. 78 in the Sauve–Kapandji group72 in the Darrach group
The mean pain scores in the Modified Mayo20 in the Sauve–Kapandji group 19 in the Darrach group
23/08/2015 2525• Bibliographie
COMPARISON II
introduction
anatomy
biomechanic
arthrosis
comparison
The Sauve-Kapandji procedure and the Darrach procedure for distal radio-ulnar joint dysfunction after Colles' fracture. George MS, Kiefhaber TR, Stern PJ.J Hand Surg Br. 2004 Dec;29(6):608-13. PMID: 15542225
23/08/2015 2626• Bibliographie
COMPARISON III
introduction
anatomy
biomechanic
arthrosis
comparison
32 wrists in the S–K31 wrists in Darrachexamined before and after surgery:clinical evaluations of pain, swelling, range of motion, grip strength, and radiological findings
Comparison of the Sauvé-Kapandji procedure and the Darrach procedure for thetreatment of rheumatoid wrists. Nakagawa N, Abe S, Kimura H, Imura S, Nishibayashi Y,Yoshiya S.Mod Rheumatol. 2003 Sep;13(3):239-42. doi: 10.3109/s10165-003-0229-6.
23/08/2015 2727• Bibliographie
COMPARISON III
introduction
anatomy
biomechanic
arthrosis
comparison
Comparison of the Sauvé-Kapandji procedure and the Darrach procedure for thetreatment of rheumatoid wrists. Nakagawa N, Abe S, Kimura H, Imura S, Nishibayashi Y,Yoshiya S.Mod Rheumatol. 2003 Sep;13(3):239-42. doi: 10.3109/s10165-003-0229-6.
23/08/2015 2828• Bibliographie
COMPARISON III
introduction
anatomy
biomechanic
arthrosis
comparison
Comparison of the Sauvé-Kapandji procedure and the Darrach procedure for thetreatment of rheumatoid wrists. Nakagawa N, Abe S, Kimura H, Imura S, Nishibayashi Y,Yoshiya S.Mod Rheumatol. 2003 Sep;13(3):239-42. doi: 10.3109/s10165-003-0229-6.
23/08/2015 2929• Bibliographie
COMPARISON III
introduction
anatomy
biomechanic
arthrosis
comparison
Comparison of the Sauvé-Kapandji procedure and the Darrach procedure for thetreatment of rheumatoid wrists. Nakagawa N, Abe S, Kimura H, Imura S, Nishibayashi Y,Yoshiya S.Mod Rheumatol. 2003 Sep;13(3):239-42. doi: 10.3109/s10165-003-0229-6.
23/08/2015 3030• Bibliographie
COMPARISON: TAKE HOME
introduction
anatomy
biomechanic
arthrosis
comparison
STUDY I (1-0)Sauvé-Kapandji: better postOP force distribution (not significative)
STUDY II (2-1)results show that the Darrach and Sauve–Kapandji procedure yield comparable and unpredictable results
STUDY III (3-1)the S–K procedure is superior to the Darrach procedure in reducing ulnar migration,and improving grip
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Merci
Camillo Theo Müller, MD
@camillomueller