Successful Surgical Treatment of Pigmented Villonodular Synovitis in the Distal Radial Ulnar Joint with Sauvé-Kapandji Procedure: A Case Report

Nova Southeastern University, Davie, Florida, USA

Introduction. Pigmented villonodular synovitis (PVNS) is described as a rare, benign condition seldomly affecting the wrist, elbow, or hand. Although current literature does not describe a standardized treatment for PVNS, surgical intervention, usually total or subtotal synovectomy, is commonly used to treat the disease. This case is one of the first in evaluating the efficacy of the Sauvé-Kapandji procedure as a treatment modality for PVNS of the wrist. Case Presentation. A 58-year-old, Hispanic male presented with right wrist pain, worsening for several months and reported an unspecified injury to the wrist approximately 1 year prior. Deviation From the Expected. Estimated annual incidence of PVNS in the United States is approximately 1.8 cases per million patients and less commonly affects smaller joints such as the wrist, which make up about 2.53% of all cases. Likely due to the rarity of the disease, there is no standardized treatment for PVNS. In this case, the decision was made to employ the Sauvé – Kapandji procedure with partial extensor tenosynovectomy. Discussion. The Sauvé – Kapandji procedure is a form of arthrodesis for the distal radioulnar joint (DRUJ) and is used to treat a myriad of conditions including various DRUJ instabilities and early synovitis in rheumatoid patients. It was elected for this case because of its increased reliability and durability in treating joint disorders. Conclusion. Although PVNS of the wrist is a relatively rare condition with no current standardized treatment, implementation of the Sauvé – Kapandji procedure can lead to favorable patient outcomes.