[Rehabilitation of the rheumatoid dorsal wrist by the Sauve-Kapandji operation combined with a realignment-stabilization synovectomy].

The authors present a series of 25 cases of rheumatoid wrists, operated by tendon and intra-carpal synovectomy, accompanied by an arthrodesis of the lower ulnar articulation following a metaphyseal resection of the lower extremity of the ulnar according to Sauve and Kapandji. This series is "young", as the mean follow-up is 2 years. It involves 25 patients, including 4 operated on both wrists. This series has the advantage of being coherent as all the operations were performed by the same surgeon. The results concerning pain are good; 87% of the wrists were painless or only periodically painful, and 88% of the patients say they are well or very much better. This operation offers the satisfying aspect of prevention; an absence of pain in the wrist when inflamed and the absence of complications such as ruptured tendons. The study of the range of motion shows a global loss of 9% in the sagittal plane and a significant reduction in the score for motion in palmar flexion. The radiological signs of deterioration of carpitis are not stopped despite the operation but it does seem to be slowed down after intra-carpal synovectomy. Ulnar sliding has been carefully studied. We observe that a further sliding is more obvious in the Larsen 2 phase than in the Larsen 3 phase. This sliding is very slight. The comparison between the different series shows that operation protects the wrist from ulnar sliding more than ulnar head resections.