Extensor Tendon Rupture Due to Osteoarthritis of the Distal Radio-Ulnar Joint

1991 ◽  
Vol 16 (4) ◽  
pp. 450-453 ◽  
Author(s):  
I. OHSHIO ◽  
T. OGINO ◽  
A. MINAMI ◽  
H. KATO ◽  
A. MIYAKE
Keyword(s):  
Tendon Transfer ◽  
Tendon Rupture ◽  
Extensor Tendon ◽  
Distal Radioulnar Joint ◽  
Tendon Graft ◽  
Distal Ulna ◽  
Radioulnar Joint ◽  
Dorsal Aspect ◽  
Closed Rupture ◽  
Little Finger

Five cases of closed rupture of the finger extensor tendon due to osteoarthritis of the distal radioulnar joint were studied. Difficulty in extension began at the little finger and extended to the ring and long fingers. Pain and swelling in the dorsal aspect of the wrist preceded the tendon rupture. Osteoarthritic changes at the distal radio-ulnar joint were more severe than those at the radio-carpal and intercarpal joints. The distal end of the ulna showed the plus variant, as well as dorsal dislocation or subluxation. All patients underwent a tendon graft or tendon transfer, with excision of the distal ulna. The tendon rupture was thought to be caused mainly by friction between the displaced distal end of the ulna and osteophytes of the distal radio-ulnar joint.

Range of Motion after the Sauvé–Kapandji and Darrach Procedures without Extensor Tendon Rupture

2020 ◽  
Author(s):  
Tomoyuki Kato ◽  
Taku Suzuki ◽  
Makoto Kameyama ◽  
Masato Okazaki ◽  
Yasushi Morisawa ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Tendon Rupture ◽  
Extensor Tendon ◽  
Distal Radioulnar Joint ◽  
Wrist Flexion ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
The Mean ◽  
Therapeutic Study ◽  
Loss Of Motion

Abstract Background Previous study demonstrated that distal radioulnar joint (DRUJ) plays a biomechanical role in extension and flexion of the wrist and suggested that fixation of the DRUJ could lead to loss of motion of the wrist. Little is known about the pre- and postoperative range of motion (ROM) after the Sauvé–Kapandji (S-K) and Darrach procedures without tendon rupture. To understand the accurate ROM of the wrist after the S-K and Darrach procedures, enrollment of patients without subcutaneous extensor tendon rupture is needed. Purpose This study aimed to investigate the pre- and postoperative ROM after the S-K and Darrach procedures without subcutaneous extensor tendon rupture in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Methods This retrospective study included 36 patients who underwent the S-K procedure and 10 patients who underwent the Darrach procedure for distal radioulnar joint disorders without extensor tendon rupture. Pre- and postoperative ROMs after the S-K and Darrach procedures were assessed 1 year after the surgery. Results In the S-K procedure, the mean postoperative ROM of the wrist flexion (40 degrees) was significantly lower than the mean preoperative ROM (49 degrees). In wrist extension, there were no significant differences between the mean preoperative ROM (51 degrees) and postoperative ROM (51 degrees). In the Darrach procedure, the mean postoperative ROM of the wrist flexion and extension increased compared with the mean preoperative ROM; however, there were no significant differences. Conclusion In the S-K procedure, preoperative ROM of the wrist flexion decreased postoperatively. This study provides information about the accurate ROM after the S-K and Darrach procedures. Level of Evidence This is a Level IV, therapeutic study.

Ulnar Stump Stabilization Using the Flexor Carpi Ulnaris Tendon for the Rheumatoid Wrist

2019 ◽  
Vol 24 (04) ◽  
pp. 447-451 ◽  
Author(s):  
Asami Abe ◽  
Hajime IshikawaKim
Keyword(s):  
Computed Tomography ◽  
Tendon Rupture ◽  
Extensor Tendon ◽  
Distal Radioulnar Joint ◽  
Forearm Rotation ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Ulnar Head Resection ◽  
Flexor Carpi Ulnaris ◽  
Grip Power

Background: The objective of this retrospective study was to evaluate the outcomes of ulnar stump stabilization after ulna head resection using the FCU tendon by investigating the rate of postoperative extensor tendon rupture and click on forearm rotation. Methods: Wrist synovectomy (distal radioulnar joint (DRUJ), radiocarpal and midcarpal joints) and ulnar head resection combined with ulnar stump stabilizing procedure were performed in 58 wrists of 53 patients with RA in our hospital. Before operation, the dorsal subluxation ratio (DSR) of the ulnar head was measured with a multi-slice computed tomography (CT) images. The stabilization of ulnar stump after head resection was performed by the value of the DSR or the instability before the operation. Results: There was neither extensor tendon rupture nor click on forearm rotation in all the patients. Smooth forearm rotation was achieved by ulnar head resection and stabilizing procedure for the ulnar stump. The active range of forearm supination and pronation increased significantly from 68° ± 23° (mean ± SD) to 80° ± 10°, and from 69° ± 17° to 74° ± 13°. The grip power increased from 117 ± 62 mmHg to 185 ± 55 mmHg. In the assessment using 3DCT, the preoperative DSR of 54% improved to 8% on the whole (n = 58). In the wrists with extensor tendon rupture (n = 36), the preoperative DSR of 58% improved to 12%. In the wrists without tendon rupture (n = 22), the preoperative DSR of 46% improved to 2%. Conclusions: The operative technique of ulnar stump stabilization using the FCU tendon was one of the suitable procedure to prevent complications after ulnar head resection.

Extensor Tendon Rupture Associated with Osteoarthritis of the Distal Radioulnar Joint

2008 ◽  
Vol 33 (4) ◽  
pp. 469-474 ◽  
Author(s):  
H. YAMAZAKI ◽  
S. UCHIYAMA ◽  
Y. HATA ◽  
N. MURAKAMI ◽  
H. KATO
Keyword(s):  
Risk Factors ◽  
Tendon Rupture ◽  
Extensor Tendon ◽  
Distal Radioulnar Joint ◽  
X Rays ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Sigmoid Notch ◽  
Tendon Ruptures ◽  
Grade 3

Non-rheumatoid osteoarthritis of the distal radioulnar joint can cause extensor tendon rupture. We analysed the radiographic morphology of the distal radioulnar joint to identify the risk factors for this complication. Forty-one wrist X-rays of 37 patients with extensor tendon rupture caused by distal radioulnar joint osteoarthritis were evaluated retrospectively for the severity of osteoarthritis by the Kellgren/Lawrence scoring system. Measurements were obtained from posteroanterior views. All but one wrist had severe osteoarthritic changes exceeding grade 3. The radiographic features that were different from those of the contralateral wrists included deepening and widening of the sigmoid notch, radial shift of the ulnar head and dorsal inclination of the sigmoid notch. There was no significant association between tendon rupture and the morphology of the ulnar head or ulnar variance. The scallop sign, dorsal inclination of the sigmoid notch and radial shift of the ulnar head are radiological risk factors for extensor tendon ruptures.

Closed Rupture of the Flexor Tendons of the Little Finger Secondary to Non-Union of Fractures of the Hook of the Hamate

2006 ◽  
Vol 31 (3) ◽  
pp. 337-341 ◽  
Author(s):  
H. YAMAZAKI ◽  
H. KATO ◽  
Y. NAKATSUCHI ◽  
N. MURAKAMI ◽  
Y. HATA
Keyword(s):  
Tendon Transfer ◽  
Tendon Rupture ◽  
Flexor Tendon ◽  
Middle Part ◽  
Active Motion ◽  
Non Union ◽  
Closed Rupture ◽  
Flexor Tendon Rupture ◽  
Tendon Grafts ◽  
Little Finger

We report six patients with closed flexor tendon rupture affecting the little finger, occurring secondarily to non-union of the hook of the hamate bone. The ununited fragments were separated from the basal part of the hook by more than 1 mm. The fragments were also rounded and showed marginal sclerosis. Non-union was located in the middle part of the hook in three patients, the tip in two, and the base in one. At operation, the fragments were removed in all patients. Five patients were treated by free tendon grafts using three palmaris and two plantaris grafts and one underwent tendon transfer. Postoperative total range of active motion of the little finger averaged 218° (range 185–265°). All patients returned to their original employment. This series would suggest that flexor tendon rupture can occur after fracture of the hook of the hamate bone, even when the ununited fragment is small and/or rounded.

scholarly journals Extensor Tendon Rupture After Distal Radioulnar Joint Surgery: A Case Series

Cureus ◽  
2021 ◽  
Author(s):  
Connor Fletcher ◽  
Francis J Sirch ◽  
Daniel Fletcher ◽  
Jonas Matzon ◽  
Pedro Beredjiklian
Keyword(s):  
Tendon Rupture ◽  
Case Series ◽  
Extensor Tendon ◽  
Distal Radioulnar Joint ◽  
Radioulnar Joint ◽  
Joint Surgery

scholarly journals Extensor Tendon Rupture Following Osteoarthritis of the Distal Radioulnar Joint

2011 ◽  
Vol 60 (1) ◽  
pp. 65-68
Author(s):  
Keisuke Saita ◽  
Hiroshi Yasunaga ◽  
Ken Takeda ◽  
Nobuhiko Watanabe
Keyword(s):  
Tendon Rupture ◽  
Extensor Tendon ◽  
Distal Radioulnar Joint ◽  
Radioulnar Joint

scholarly journals Distal radioulnar joint stabilization with open foveal reinsertion versus tendon graft reconstruction: an experimental study using radiostereometry

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Janni Kjærgaard Thillemann ◽  
Sepp De Raedt ◽  
Torben Bæk Hansen ◽  
Bo Munk ◽  
Maiken Stilling
Keyword(s):  
Experimental Study ◽  
Surgical Techniques ◽  
Distal Radioulnar Joint ◽  
Tendon Graft ◽  
Imaging Method ◽  
Radioulnar Joint ◽  
Clinical Recommendation ◽  
Surgical Methods ◽  
Custom Made ◽  
Stabilizing Effect

Abstract Purpose Symptomatic instability of the distal radioulnar joint (DRUJ) caused by lesion of the Triangular Fibrocartilage Complex (TFCC) can be treated with a number of surgical techniques. Clinical examination of DRUJ translation is subjective and limited by inter-observer variability. The aim of this study was to compare the stabilizing effect on DRUJ translation with two different surgical methods using the Piano-key test and a new precise low-dose, non-invasive radiostereometric imaging method (AutoRSA). Methods In a randomized experimental study we evaluated the DRUJ translation in ten human cadaver arms (8 males, mean age 78 years) after cutting the proximal and distal TFCC insertions, and after open surgical TFCC reinsertion (n = 5) or TFCC reconstruction using a palmaris longus tendon graft ad modum Adams (n = 5). The cadaver arms were mounted in a custom-made fixture for a standardized Piano-key test. Radiostereometric images were recorded and AutoRSA software was used for image analyses. Standardised anatomical axes and coordinate systems of the forearm computer tomography bone models were applied to estimate DRUJ translation after TFCC lesions and after surgical repair. Results The DRUJ translation after cutting the proximal and distal TFCC insertions was 2.48 mm (95% CI 1.61; 3.36). Foveal TFCC reinsertion reduced DRUJ translation by 1.78 mm (95% CI 0.82; 2.74, p = 0.007), while TFCC reconstruction reduced DRUJ translation by 1.01 mm (95% CI -1.58; 3.60, p = 0.17). Conclusion In conclusion, foveal TFCC reinsertion significantly decreased DRUJ translation while the stabilizing effect of Adams TFCC reconstruction was heterogeneous. This supports the clinical recommendation of TFCC reinsertion in patients suffering from symptomatic DRUJ instability due to acute fovea TFCC lesions.

Distal Radioulnar Joint Osteoarthritis: An Update on Treatment Options

2021 ◽  
Author(s):  
Brian M. Katt ◽  
Amr Tawfik ◽  
Nicholas Zingas ◽  
Francis Sirch ◽  
Pedro K. Beredjiklian ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Distal Radius ◽  
Joint Instability ◽  
Conservative Therapy ◽  
Treatment Options ◽  
Distal Radioulnar Joint ◽  
Surgical Approaches ◽  
Distal Ulna ◽  
Load Bearing ◽  
Radioulnar Joint

AbstractThe distal radioulnar joint (DRUJ), the articulation between the sigmoid notch of the radius and the distal ulna, plays a pivotal role in stability and load bearing and allows for pronation and supination of the forearm. Osteoarthritis (OA) of the DRUJ commonly occurs due to distal radius trauma but may also be the result of conditions such as joint instability, septic arthritis, or primary OA. It is initially managed with conservative therapy, but surgery is often considered when nonoperative methods fail. The surgical approaches available to treat this pathology have grown over the years. The procedures have generally favorable outcomes, each with their own unique complications and considerations. This paper comprises a review of the outcomes and complications for the different procedures commonly used to surgically treat DRUJ OA.

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