Objective: We examined the surgical outcomes of the Sauvé–Kapandji (S–K) procedure using a headless compression screw and a metal cancellous screw in patients with rheumatoid arthritis (RA). Methods: This retrospective study included 41 RA patients who underwent the S–K procedure for distal radioulnar joint disorders with two screws: headless compression screws (HCS group, n = 20) and cannulated cancellous screws (CCS group, n = 21). Clinical and radiographic outcomes were assessed 1 year after surgery. Radiographic outcomes included bony union of the distal radioulnar joint (DRUJ), bone resorption around the screw, a screw back-out, and use of additional K-wire. We investigated any complications related to the screw head. Results: All 20 patients in the HCS group showed bone fusion of the DRUJ. In the CCS group, an asymptomatic non-union was observed in one patient and additional K-wire was needed to stabilize the DRUJ in three patients. No patients complained of any complications related to the screw head in the HCS group, while the CCS group demonstrated the hardware protrusion in two patients who complained of tenderness or discomfort at the screw head. Conclusions: The use of a headless compression screw in the S–K procedure is useful in patients with RA.
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