Sauvé-Kapandji procedure versus radio-lunate arthrodesis in the treatment of Madelung deformity. A case report

Madelung deformity consists of excessive ulnar and palmar angulation of the distal radius. It may also involve the radiocapitellar joint and the sagittal bow of the radius. Commonly, the disease becomes clinically apparent in young adolescents with wrist deformity, pain and limited range of movement. There are multiple options for operative treatment. We retrospectively assessed a 14-year-old-girl treated in our department. The patient required treatment due to exacerbating pain in both wrists. The left hand underwent resection of the distal ulna; however, persistent pain led to the decision to perform the radiolunate arthrodesis (RL). The right hand was treated according to the Sauvé-Kapandji procedure. Three years post-surgery, the patient was called for a follow-up examination. The assessment included measuring the range of motion using a goniometer, grip strength with a dynamometer, and evaluating follow-up wrist X-rays in lateral and posteroanterior views. The patient has also been evaluated using the Patient-Rated Wrist Evaluation (PRWE) and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires. Three years post-operation, the patient reported the absence of rest pain and occasional pain during loading. With the Sauvé-Kapandji procedure, a greater range of palmar flexion of the wrist and improved strength was achieved. The patient scored 5.83 points on the DASH scale, 9.5 points on the left hand, and 8.5 points on the right hand on the PRWE scale. In this patient’s case, better outcomes were achieved by employing the Sauvé-Kapandji procedure. The patient’s right-handedness may have influenced the results.