Functional restoration after sauvé–kapandji procedure for post-traumatic druj instability: A case report

Distal Radioulnar Joint (DRUJ) instability following post-traumatic Madelung-like deformity is rare in skeletally mature patients and presents a challenge in restoring pain-free pronation–supination. We report the case of a 19-year-old woman with progressive ulnar-sided wrist pain, dorsal bowing of the forearm, and limitation of pronosupination and wrist flexion–extension after a remote fall injury. Radiographs and MRI revealed increased radial inclination, proximal migration of the lunate with a V-shaped carpus, volar subluxation of the hand, and traumatic DRUJ instability. Given the patient’s age, functional demand, and persistent pain, a modified Sauvé–Kapandji procedure was performed. Postoperatively, the limb was immobilised for 4 weeks followed by supervised rehabilitation. At 6-month follow-up, she had pain relief with no symptomatic instability of the proximal ulnar stump, grip strength of 60–70% of the contralateral side, Mayo Clinic wrist score of 70–75, and DASH score around 50, indicating satisfactory functional recovery. This case highlights the effectiveness of the Sauvé–Kapandji procedure in managing post-traumatic DRUJ instability with acceptable restoration of motion and grip strength.