Darrach vs. Sauve-Kapandji: A Comprehensive Meta-Analysis of Surgical Outcomes in Distal Radioulnar Joint (DRUJ) Dysfunction

Minh H Nguyen; Nicholas Lipari; Andrew L O'Brien; Richard Samade; Sonu A Jain

doi:10.1007/s43465-023-00826-5

Darrach vs. Sauve-Kapandji: A Comprehensive Meta-Analysis of Surgical Outcomes in Distal Radioulnar Joint (DRUJ) Dysfunction

Indian J Orthop. 2023 Feb 12;57(4):565-570. doi: 10.1007/s43465-023-00826-5. eCollection 2023 Apr.

Authors

Minh H Nguyen¹, Nicholas Lipari², Andrew L O'Brien¹, Richard Samade³, Sonu A Jain¹

Affiliations

¹ Hand and Upper Extremity Center, Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, 915 Olentangy River Road, Suite 3200, Columbus, OH 43212 USA.
² The Ohio State University College of Medicine, Columbus, USA.
³ Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, USA.

Abstract

Introduction: Optimal treatment of chronic distal radioulnar joint (DRUJ) arthritis and instability remains unresolved in the literature. Specifically, no systematic comparison of two common options, Sauve-Kapandji (SK) and Darrach's, is available.

Methods: A meta-analysis was performed utilizing the PUBMED and EMBASE databases and yielded a total of 47 available studies. Objective outcomes, such as wrist range of motion (ROM), forearm ROM, grip strength, and subjective outcomes, including pain and rate of return to work, were recorded. Statistical analysis was done using t test and chi-square test.

Results: For both the SK and Darrach's procedures, forearm ROM was significantly better postoperatively in both pronation (p = 0.0001 for both groups) and supination (p = 0.0001 for both groups). Wrist flexion decreased in the SK group (p = 0.0007), but no difference was found for wrist extension (p = 0.09). The Darrach's group showed a significance improvement in wrist extension (p = 0.0001). Grip strength was improved in the SK group (p < 0.0001), but not in the Darrach's group (p = 0.7831). No difference existed between the SK and Darrach's groups in proportion of patients who were pain-free. The SK group had higher numbers of patients return to work (p = 0.0057). There was not enough data from the studies to make any meaningful analysis in term of treatment failure and complications.

Conclusions: Overall, both the SK and Darrach's procedures helped improve pain, wrist ROM, and forearm ROM in patient with chronic DRUJ disorders. The SK procedure can have advantages over the Darrach's procedures in terms of grip strength and rate of return to work.

Supplementary information: The online version contains supplementary material available at 10.1007/s43465-023-00826-5.

Keywords: Arthritis; Darrach procedure; Distal radioulnar joint; Sauve-Kapandji procedure.

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