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J Wrist Surg 2024; 13(04): 328-332
DOI: 10.1055/s-0043-1775994
Scientific Article

Outcomes of Surgical Treatment of Vaughan-Jackson Syndrome

Joshua L. Mcintyre
1   Department of Trauma and Orthopaedics, Queen Margaret Hospital, Dunfermline, NHS Fife, Kirkcaldy, United Kingdom
,
Paul H.C. Stirling
1   Department of Trauma and Orthopaedics, Queen Margaret Hospital, Dunfermline, NHS Fife, Kirkcaldy, United Kingdom
,
Jane Mceachan
1   Department of Trauma and Orthopaedics, Queen Margaret Hospital, Dunfermline, NHS Fife, Kirkcaldy, United Kingdom
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Abstract

Background Vaughan-Jackson syndrome (VJS) is the attritional rupture of the extensor tendons secondary to arthritis or inflammation affecting the distal radioulnar joint. The surgical outcomes following Darrach's procedure and tendon transfers are not well described. The primary aim of this study was to report patient-reported functional outcome measures after surgery for VJS. Secondary aims were to report health-related quality-of-life scores, patient satisfaction, and complications

Methods A single-center retrospective study was performed to identify patients who underwent surgical intervention for the management of VJS. Patient-reported outcomes were measured using the Patient-Rated Wrist and Hand Evaluation (PRWHE), Quick version of the Disability of the Arm, Shoulder, and Hand (QuickDASH), EuroQoL 5-dimensions 5-Likert (EQ-5D-5L), and calculation of the Net Promoter Score (NPS).

Results We report postoperative patient-reported functional outcome measures for 12 cases of VJS treated with distal ulna excision and extensor tendon transfer. The mean age was 69 years (range: 45–87 years; standard deviation [SD]: 14.1), and eight patients were females. Five patients had rheumatoid arthritis, and there was one case each of seronegative polyarthritis, ankylosing spondylitis, and CREST (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia.) syndrome; the rest of the patients had osteoarthritis. At a mean of 53 months of follow-up, the mean PRWHE score was 34.5 (SD: 17.9), the mean QuickDASH score was 28.2 (SD: 18.6), and the mean EQ-5D-5L score was 0.71 (SD: 0.203). Ten patients were satisfied and the NPS was 42. Postoperatively eight patients had pain scores reported as none or mild, three as moderate, and one as severe. Two patients required further operations, both undergoing total wrist arthrodesis.

Conclusion Although a degree of functional deficit persists after Darrach's procedure and tendon transfer for treatment of VJS, there are also high levels of patient satisfaction, a good NPS, and a low rate of operative reintervention.

Level IV evidence.

Keywords

Vaughan-Jackson - distal radioulnar joint - tendon rupture - tendon transfer

Confirmation of Authorship

All authors listed above meet the conditions of the ICMJE criteria.


Ethical Approval

No ethical approval was required as this study acted as a retrospective evaluation of service.


Informed Consent

There is no information (names, initials, hospital identification numbers, or photographs) in the submitted manuscript that can be used to identify patients. Verbal informed consent was obtained from all subjects before the study.


Author Contributions

J.McE. conceived the study. J.L.M. was involved in patient data collection and data analysis. J.L.M. wrote the first draft of the manuscript. J.L.M., P.H.C.S., and J.McE. reviewed and edited the manuscript and approved the final version of the manuscript.




Publication History

Received: 23 March 2023

Accepted: 12 September 2023

Article published online:
16 January 2024

© 2024. Thieme. All rights reserved.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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