Biomechanical Comparison of Graft Preparation Techniques for Distal Radioulnar Joint Reconstruction

Abstract Purpose This study aims to describe and biomechanically evaluate a novel technique using a strip of the flexor carpi ulnaris tendon for distal radioulnar joint reconstruction. Methods Surgical technique was thoroughly detailed, and a cadaveric biomechanical test was conducted to evaluate sagittal plane stability. Pronosupination range of motion was measured before and after the procedure. Dorsal and volar translation resistances were checked in three situations: with the uninjured triangular fibrocartilage complex, after its complete resection and after the surgical procedure. Results For distal radioulnar joint translation, higher values were found both in dorsal and volar translation in situations with an injured triangular fibrocartilage complex, with means equal to 25.4 mm (SD: 9.4 mm) and 26.1 mm (SD: 8.0 mm), respectively. For intact triangular fibrocartilage complex, both dorsal and volar translations averages were 3.4 mm (SD: 0.9 mm) and 4.5 mm (SD: 1.8 mm), respectively. Finally, when evaluating dorsal and volar translations after surgical reconstruction, means were 6.3 mm (SD: 1.3 mm) and 6.8 mm (SD: 0.9 mm), respectively. Regarding supination and pronation range of motion, which ranged from 57.9 to 63.4o, there were no differences in mean and median measures, when the cadavers with intact and reconstructed triangular fibrocartilage complex were compared (p > 0.05). Conclusion Promising mechanical evaluations encourage us to hypothesize that the technique effectively reconstructs the dorsal and volar radioulnar ligaments, preserving pronosupination and maintaining the physiological characteristics of the wrist joint. Clinical comparative studies are still necessary to fully validate this procedure. Level of evidence Therapeutic - Level V.

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Biomechanical Study of Distal Radioulnar Joint (DRUJ) Ballottement Test

Journal of Wrist Surgery ◽

10.1055/s-0035-1545640 ◽

2015 ◽

Vol 04 (S 01) ◽

Author(s):

Shohei Omokawa ◽

Hisao Moritomo

Keyword(s):

Distal Radioulnar Joint ◽

Biomechanical Study ◽

Radioulnar Joint

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

Journal of Wrist Surgery ◽

10.1055/s-0040-1721452 ◽

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.

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