Ulnar Shortening for the Treatment of Early Post-Traumatic Osteoarthritis at the Distal Radioulnar Joint

2001 ◽  
Vol 26 (1) ◽  
pp. 41-44 ◽  
Author(s):  
L. R. SCHEKER ◽  
A. SEVERO
Keyword(s):  
Contact Area ◽  
Distal Radioulnar Joint ◽  
Early Osteoarthritis ◽  
Self Assessment ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Relieve Pain ◽  
Post Traumatic ◽  
The Mean

This prospective study describes the outcome of ulnar shortening performed on 32 wrists with early osteoarthritis of the distal radiounlar joint (DRUJ) in an attempt to change the contact area between the ulnar head and the radial sigmoid notch. By changing the contact area, we attempted to relieve pain, while maintaining the function of the DRUJ. The mean age of the patients was 34 years, and the mean follow-up was three years and two months. The wrists were graded by the patients’ self-assessment of satisfaction and by a clinical wrist rating that assessed pain, functional status, range of motion, and grip strength. In terms of self-assessment, 16/32 patients were very satisfied, with complete pain relief. Of the 32 patients, 26 said that they would have surgery again if circumstances were similar. The postoperative wrist ratings were 7/32 excellent, 11/32 good, 9/32 fair, 5/32 poor. The most frequent postoperative complaint was plate irritation.

scholarly journals The Optimal Suture Placement and Bone Tunnels for TFCC Repair: A Cadaveric Study

2018 ◽  
Vol 07 (05) ◽  
pp. 375-381 ◽  
Author(s):  
Peter Tang ◽  
Keiji Fujio ◽  
Robert Strauch ◽  
Melvin Rosenwasser ◽  
Taiichi Matsumoto
Keyword(s):  
Distal Radioulnar Joint ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Transosseous Repair ◽  
Triangular Fibrocartilage ◽  
The Mean ◽  
Group 5 ◽  
Bone Tunnels ◽  
Isometric Point ◽  
Suture Placement

Background Transosseous repair of foveal detachment of the triangular fibrocartilage complex (TFCC) is effective for distal radioulnar joint stabilization. However, studies of the optimal foveal and TFCC suture positions are scant. Purpose The purpose of this study was to clarify the optimal TFCC suture position and bone tunnels for transosseous foveal repair. Materials and Methods Seven cadavers were utilized. The TFCC was incised at the foveal insertion and sutured at six locations (TFCCs 1–6) using inelastic sutures. Six osseous tunnels were created in the fovea (foveae 1–6). Fovea 2 is located at the center of the circle formed by the ulnar head overlooking the distal end of the ulna (theoretical center of rotation); fovea 5 is located 2 mm ulnar to fovea 2. TFCC 5 is at the ulnar apex of the TFCC disc; TFCC 4 is 2 mm dorsal to TFCC 5. TFCC 1 to 6 sutures were then placed through each of the six osseous tunnels, resulting in 36 combinations, which were individually tested. The forearm was placed in five positions between supination and pronation, and the degree of suture displacement was measured. The position with the least displacement indicated the isometric point of the TFCC and fovea. Results The mean distance of suture displacement was 2.4 ± 1.6 mm. Fovea 2, combined with any TFCC location, (0.7 ± 0.6 mm) and fovea group 5, combined with TFCC 4 location (0.8 ± 0.8) or with TFCC 5 location (0.9 ± 0.6) had statistically shorter suture displacements than any other fovea groups. Conclusion For TFCC transosseous repair, osseous tunnel position was more important than TFCC suture location.

PROXIMAL ULNAR STUMP STABILITY AFTER USING THE PRONATOR QUADRATUS MUSCLE TRANSFER COMBINED WITH THE SUAVÉ-KAPANDJI PROCEDURE IN RHEUMATOID WRIST

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 25-32 ◽  
Author(s):  
Chairoj Uerpairojkit ◽  
Somsak Leechavengvongs ◽  
Kanchai Malungpaishorpe ◽  
Kiat Witoonchart ◽  
Panai Buddhavibul
Keyword(s):  
Sagittal Plane ◽  
Distal Radioulnar Joint ◽  
Muscle Transfer ◽  
Pronator Quadratus ◽  
Radioulnar Joint ◽  
Rheumatoid Wrist ◽  
Joint Disorder ◽  
The Mean ◽  
Pronator Quadratus Muscle

The pronator quadratus muscle transfer combined with the Sauvé-Kapandji procedure was used to treat the distal radioulnar joint disorder in ten rheumatoid wrists for prevention against instability of the proximal ulnar stump. All patients were female with a mean age of 46.6 years. The mean follow-up time was 24.2 months. Postoperatively, supination increased in all patients with a mean of 50 degrees. Pain decreased significantly and none complained of prominence of the proximal ulnar stump in normal pronated position and during a tight grip. The wrist radiographs of both coronal and sagittal planes in normal and stress fisting views were used to evaluate the postoperative static and physiologic loaded stability of the proximal ulnar stump. It had shown this procedure provided good static proximal ulnar stump stability in both coronal and sagittal planes. However, in physiologic loaded condition, it was able to provide stability only in the sagittal plane.

Clinical, radiological and patient-rated outcome comparison between total and partial ulnar head implants

2021 ◽  
pp. 175319342110484
Author(s):  
Lea Estermann ◽  
Lisa Reissner ◽  
Andrea B. Rosskopf ◽  
Andreas Schweizer ◽  
Ladislav Nagy
Keyword(s):  
Grip Strength ◽  
Distal Radioulnar Joint ◽  
Joint Arthroplasty ◽  
Dash Score ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Outcome Comparison ◽  
Pain At Rest

This study aimed to analyse the clinical and radiological outcomes after ulnar head replacement and to compare partial and total ulnar head implants. Twenty-two patients with 23 implants were available with a mean follow-up time of 7 years (range 1.3 to 17) after distal radioulnar joint arthroplasty. At the final follow-up, patients had a low level of pain at rest and during effort, a median Disabilities of the Arm, Shoulder, and Hand (DASH) score of 12 and Patient-Rated Wrist Evaluation score of 12 with partial ulnar head implants, and scores of 20 and 22 in total ulnar head implants, respectively. While the range of motion in patients with partial ulnar head implants was slightly reduced in comparison with the preoperative condition and to the patients with total ulnar head implants, there was a tendency to a higher grip strength and rotational torque. Both types of prosthesis showed sigmoid notch resorptions and resorptions around the neck. We conclude that the results after partial ulnar head replacement do not significantly differ from the total ulnar head implants in many aspects. Level of evidence: III

MODIFIED MATCHED ULNAR RESECTION FOR ARTHROSIS OF DISTAL RADIOULNAR JOINT IN RHEUMATOID ARTHRITIS

Hand Surgery ◽  
2006 ◽  
Vol 11 (01n02) ◽  
pp. 15-19 ◽  
Author(s):  
K. N. Srikanth ◽  
S. A. Shahane ◽  
J. H. Stilwell
Keyword(s):  
Rheumatoid Arthritis ◽  
Retrospective Study ◽  
Pain Relief ◽  
Distal Radius ◽  
Distal Radioulnar Joint ◽  
Rheumatoid Patient ◽  
Radioulnar Joint ◽  
Ulnar Head

The pain of distal radioulnar arthrosis in rheumatoid patients is often due to disease largely confined to the radioulnar rather than the ulnocarpal articulation. This is a retrospective study of 14 patients (14 wrists) who underwent selective shaving of the radial articulation of the ulnar head leaving the ulnocarpal articulation intact. The ulnar head is reduced to the circumference of its shaft and a dorsal retinacular flap is interposed between it and the distal radius. Average age of the patients and follow-up were 63.5 years and 31 months, respectively. All patients had rheumatoid arthritis. Pain improved in 14 out of 15 wrists. Overall results were 67% good to excellent and 33% fair based on the modified Mayo's wrist score. This novel procedure for DRUJ arthrosis produces predictable pain relief in low demand rheumatoid patient.

Clinical and radiological results of distal radioulnar joint arthroplasty with the Aptis prosthesis

2021 ◽  
pp. 175319342110636
Author(s):  
Delphine Lambrecht ◽  
Wim Vanhove ◽  
Nadine Hollevoet
Keyword(s):  
Distal Radioulnar Joint ◽  
Mean Value ◽  
Joint Arthroplasty ◽  
Wrist Flexion ◽  
Previous Surgery ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
The Mean ◽  
Clinical And Radiological Results

We report the results of the treatment of disorders of the distal radioulnar joint with the semi-constrained Aptis prosthesis. Nineteen patients were assessed at a mean follow-up of 7 years. All patients had been operated on previously at the wrist, forearm or elbow. The Disabilities of Arm, Shoulder and Hand score had a mean value of 40, the Patient-Rated Wrist Evaluation score had a mean of 49 and the visual analogue scale for pain had a mean of 3.9. The mean ranges of pronation, supination, wrist flexion and wrist extension were 78°, 76°, 60° and 51°, respectively. The mean grip strength was 23 kg. Complications were noted in ten patients. Eighteen patients would undergo the operation again. The 10-year cumulative survival rate was 84%. The Aptis prosthesis may be a solution to treat patients in whom previous surgery at the distal radioulnar joint has failed. Level of evidence: IV

Preventing recurrence of radioulnar synostosis with pedicled adipofascial flaps

2011 ◽  
Vol 37 (3) ◽  
pp. 244-250 ◽  
Author(s):  
J. Sonderegger ◽  
S. Gidwani ◽  
M. Ross
Keyword(s):  
Distal Radioulnar Joint ◽  
Forearm Rotation ◽  
Radioulnar Synostosis ◽  
Radioulnar Joint ◽  
Interosseous Artery ◽  
Posterior Interosseous Nerve Palsy ◽  
Post Traumatic ◽  
Term Maintenance

The surgical treatment of post-traumatic radioulnar synostosis is difficult. Recurrence after resection alone is a concern with poor long-term maintenance of forearm rotation. We report on the use of pedicled adipofascial flaps to prevent recurrence and facilitate maintenance of movement in six adult patients with radioulnar synostosis. Five involved the proximal radioulnar joint and one the distal radioulnar joint. In four the flap was based on the radial artery and in two on the posterior interosseous artery. Mean intraoperative supination was 78° and pronation was 76°. Mean follow up was 32 months. At follow-up, mean supination was 71° and pronation was 70°. No patient had radiological recurrence of synostosis. The only complication was a transient posterior interosseous nerve palsy. Pedicled adipofascial flaps are a safe addition to resection alone which may prevent recurrence and maintain the range of forearm rotation achieved at operation.

Hemiresection Interposition Arthroplasty of the Distal Radioulnar Joint: A Long-term Outcome Study

Hand ◽  
2019 ◽  
pp. 155894471987343 ◽  
Author(s):  
Femke Nawijn ◽  
Svenna H. W. L. Verhiel ◽  
Jesse B. Jupiter ◽  
Neal C. Chen
Keyword(s):  
Inflammatory Arthritis ◽  
Distal Radioulnar Joint ◽  
Long Term Outcome ◽  
Radioulnar Joint ◽  
Pain Scores ◽  
Custom Made ◽  
Patient Reported ◽  
The Mean

Background: The aim of this study was to assess factors associated with long-term patient-reported functional, pain, and satisfaction scores in patients who underwent (Bowers) hemiresection interposition technique (HIT) arthroplasty of the distal radioulnar joint (DRUJ). The secondary aims were to determine the complication and reoperation rates. Methods: A retrospective study with long-term follow-up of patients undergoing HIT arthroplasty was performed. Demographic, disease, and treatment characteristics were collected for the 66 included patients. Thirty-one patients completed all surveys, which were the Quick Disabilities of Arm, Shoulder and Hand (QuickDASH), our custom-made HIT arthroplasty questionnaire, Numeric Rating Scale (NRS) for pain, and NRS for satisfaction. The mean interval between surgery and follow-up by means of questionnaires was 8.6 ± 3.4 years. Results: The mean QuickDASH score was 31.0 ± 20.2. The mean score of the HIT arthroplasty questionnaire was 2 ± 2. The median NRS for pain was 1 (interquartile range [IQR], 0-3), and the median NRS for satisfaction was 9 (IQR, 8-10). The complication rate and reoperation rate were 14% and 8%, respectively. Conclusion: Overall, patients expressed satisfaction with HIT arthroplasty, despite a mean QuickDASH score of 31.0. In our cohort, patients with inflammatory arthritis had higher satisfaction and lower pain scores. Patients who had prior trauma, prior surgery, or DRUJ subluxation are generally less satisfied. Men, older patients, and posttraumatic patients had higher long-term pain scores; however, posterior interosseous nerve neurectomy is associated with improved pain scores. Our findings support the use of HIT arthroplasty in patients with inflammatory arthritis.

scholarly journals Indications and early to mid-term results of ulnar head replacement

2013 ◽  
Vol 95 (6) ◽  
pp. 427-432 ◽  
Author(s):  
D Warwick ◽  
G Shyamalan ◽  
E Balabanidou
Keyword(s):  
Distal Radioulnar Joint ◽  
Primary Treatment ◽  
Medium Term ◽  
Wrist Arthrodesis ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Large Patient ◽  
Almost All ◽  
Mid Term Results

Introduction The aim of this study was to explore the indications and show the early to mid-term results of ulnar head replacement for the treatment of pathological conditions of the distal radioulnar joint. Methods Our study group comprised 52 patients with a mean age of 64 years who had 56 ulnar head replacements. Seven were implanted to salvage an unstable deletive procedure; the rest were for primary treatment of osteoarthritis, rheumatoid arthritis and trauma. Concomitant procedures along with the ulnar head replacement included wrist arthrodesis, joint replacement and tendon transfers. Results The follow-up duration ranged from 1 year to 11 years (mean: 60 months, median: 60 months). In almost all of the patients, pain improved with a median visual analogue scale score of 2 (mean: 2.2, range: 0–8) and a median DASH (Disabilities of the Arm, Shoulder and Hand) score of 12.5 (mean: 17.9, range: 0–56). Of the 52 patients, 47 reported they would have the same procedure again. Conclusions Ulnar head replacement appears to be a reliable and effective procedure solving several pathological problems of the distal radioulnar joint. We present a large patient group with a short to medium-term follow-up duration.

scholarly journals FUNCTIONAL RESULTS POST-TRIANGULAR FIBROCARTILAGE COMPLEX RECONSTRUCTION WITH EXTENSOR CARPI ULNARIS WITH OR WITHOUT ULNAR SHORTENING IN CHRONIC DISTAL RADIOULNAR JOINT INSTABILITY

Hand Surgery ◽  
2005 ◽  
Vol 10 (02n03) ◽  
pp. 169-176 ◽  
Author(s):  
Jui-Tien Shih ◽  
Hung-Maan Lee
Keyword(s):  
Functional Results ◽  
Distal Radioulnar Joint ◽  
Triangular Fibrocartilage Complex ◽  
Radioulnar Joint ◽  
Extensor Carpi Ulnaris ◽  
Druj Instability ◽  
Sport Activities ◽  
Triangular Fibrocartilage ◽  
Post Traumatic

From September 1996 to September 2001, 37 adult patients were diagnosed with chronic triangular fibrocartilage complex (TFCC) tears with distal radioulnar joint (DRUJ) instability in our clinic. They had all received the procedure of TFCC reconstruction with partial extensor carpi ulnaris (ECU) combined with or without ulnar shortening. There were 36 males and one female in the study with a mean age of 22.4 years. The follow-up period ranged from 25 to 48 months with a mean of 36.2 months. All patients received the rehabilitation programme and were re-examined at our outpatient department. The results were graded according to the Mayo Modified Wrist Score. Eleven of the 37 patients rated their wrists "excellent", 22 rated "good", and four rated "fair". Overall, a total of 33 patients (89%) rated satisfactorily and returned to work or sport activities. Therefore, TFCC reconstruction with partial ECU tendon combined with or without ulnar shortening procedure is an effective method for post-traumatic chronic TFCC tears with DRUJ instability suggested by this study.

Sign in / Sign up

Export Citation Format

Share Document