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Distal radioulnar joint

Thomas J M Kootstra, Wouter F van Leeuwen, Neal Chen, David Ring
Background  There is controversy regarding the value of repair of the triangular fibrocartilage complex (TFCC). Given that an acute tear of the TFCC associated with a displaced distal radius fracture uncommonly benefits from repair, the role of repair in other settings is uncertain. Our impression is that TFCC repair is highly variable from surgeon-to-surgeon. Purpose  The purpose of this study is to determine the rate of TFCC repair in patients who had a magnetic resonance imaging (MRI) scan of the wrist obtained for ulnar-sided wrist pain, and that showed signal changes in the TFCC...
July 2018: Journal of Wrist Surgery
R Schmitt
X-ray images exposed in neutral position and radiocarpally centred are essential in imaging of the distal radioulnar joint (DRUJ). The anatomic orientation of the DRUJ is favourable for acquiring transaxial scans to display its anatomy, subtle derangements, osteoarthritis and intra-articular fractures free from superpositions. The triangular fibrocartilage complex (TFCC) is the most important stabilizer of the DRUJ. Provided that a focused clinical indication is given, high-resolution images are acquired, and an intra-venous or intra-articular contrast-agent is applied, all TFCC structures and destabilizing lesions can be displayed with the use of CT and MRI...
June 18, 2018: Der Orthopäde
Todd A Rubin, Matthew J Gluck, Michael R Hausman
Essex-Lopresti Lesions are rare injuries that are often missed in the acute setting. Delayed intervention may lead to chronic wrist and elbow pain and overall poor outcomes. The literature currently supports treatments that involve shortening of the ulna to reduce the relative degree of ulnar impaction, followed by attempted reduction of the distal radioulnar joint. Although such techniques may help to temporarily reduce wrist pain secondary to ulnar impaction, they do not address the proximal migration of the radius and ipsilateral radial head dislocation at the elbow...
June 14, 2018: Techniques in Hand & Upper Extremity Surgery
Márcio Aurélio Aita, Ricardo Carvalho Mallozi, Willian Ozaki, Douglas Hideo Ikeuti, Daniel Alexandre Pereira Consoni, Gustavo Mantovanni Ruggiero
Objectives: To measure the quality of life and clinical outcomes of patients treated with interosseous membrane (IOM) ligament reconstruction of the forearm, using the brachioradialis (BR), and describe a new surgical technique for the treatment of joint instability of the distal radioulnar joint (DRUJ). Methods: From January 2013 to September 2016, 24 patients with longitudinal injury of the distal radioulnar joint DRUJ were submitted to surgical treatment with a reconstruction procedure of the distal portion of the interosseous membrane or distal oblique band (DOB)...
March 2018: Revista Brasileira de Ortopedia
T Poujade, N Balagué, J-Y Beaulieu
The aim of this study was to assess distal radioulnar joint stability after unipolar ulnar head replacement for post-Darrach instability. All the patients who underwent ulnar head replacement between1999 and 2015 for post-Darrach procedure instability at our clinic were reviewed. Seven Hebert-type and two uHead (SBI/Stryker) prostheses were implanted. None of the implants were cemented. We assessed stability, pain, range of motion and strength pre- and postoperatively. The changes in the radiographic appearance between immediate postoperative and the last follow-up were determined...
June 4, 2018: Hand Surgery and Rehabilitation
C K Spies, M Langer, L P Müller, J Oppermann, S Löw, F Unglaub
BACKGROUND: The functionality of the upper extremity is decisively based on rotation of the forearm. The rotation depends on the extent of motion of the distal radioulnar joint. Rotation enables complete and focused usability of the hand in order to cope with daily activities. The configuration of the distal radioulnar joint has developed over millions of years of evolution. ANATOMIC CONDITIONS: The triangular fibrocartilage complex is the crucial stabiliser of the latter joint since osseous structures are limited...
June 5, 2018: Der Orthopäde
Hui Qian, Guozhao Chen, Zongbao Liu
RATIONALE: Dislocation of the distal radioulnar joint and injury to distal forearm are commonly encountered. However, delayed diagnosis or misdiagnosis has been relatively rare due to improved diagnosis and treatment. Treatment of old dislocation of radioulnar joint is challenging due to development of secondary chronic instability and difficulties in restoration of joint function. PATIENT CONCERNS: This report describes three cases of patients complained about inability to extend their little fingers...
June 2018: Medicine (Baltimore)
Koichi Yano, Yasunori Kaneshiro, Hideki Sakanaka
We report a 34-year-old man who presented with ulnar wrist pain, painful click, and locking during forearm rotation following a motorcycle accident. Plain radiographs showed a loose body in the distal radioulnar joint (DRUJ), deformity of the sigmoid notch and ulnar head, and ulnar minus variant. The DRUJ deformity was assumed to be associated with physeal injury of the distal ulna during childhood. Conservative treatment with a splint and oral analgesics for 3 months failed. During DRUJ arthroscopy, osteoarthritic changes were found, and the loose body was resected using DRUJ arthroscopy...
May 22, 2018: Acta Orthopaedica et Traumatologica Turcica
Shenghe Liu, Luyuan Sun, Yimin Chai, Cunyi Fan, Yaozeng Xu
Objective: To review the clinical application progress of the Sauvé-Kapandji procedure. Methods: The indications, techniques, effectiveness, and modifications of the Sauvé-Kapandji procedure were analyzed and evaluated by an extensive review of the relevant literature. Results: The Sauvé-Kapandji procedure can be applied for various disorders of the distal radioulnar joint. Risk of series of complications exist, which might be reduced by modification of the procedure...
September 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
S Quadlbauer, C Pezzei, W Hintringer, T Hausner, M Leixnering
BACKGROUND: The distal radioulnar joint (DRUJ) provides the distal link between radius and ulnar and is the centre of rotation during pronation and supination. Pronation and supination are essential in controlling the posture and optimal presentation of the hand to grasp an object. In addition, pronation and supination enable us to rotate tools when they are in the longitudinal axis of the forearm. Due to this, the DRUJ plays a central role in the performance of activities in daily life...
May 24, 2018: Der Orthopäde
T Pillukat, M Mühldorfer-Fodor, J Windolf, J van Schoonhoven
OBJECTIVE: The aim of the procedure is to visualize the proximal pouch of the DRUJ, the joint surfaces of the sigmoid notch and the ulnar head, the convexity of the ulnar head and the proximal ulnar side surface of the triangular fibrocartilage complex (TFCC). INDICATIONS: Arthroscopy of the distal radioulnar joint is applied for the evaluation of joint pathologies in ulnar-sided wrist pain, especially in cases without diagnostic findings in standard X‑rays and MRIs and arthroscopically assisted procedures...
May 24, 2018: Der Orthopäde
M-D Kunze, F Neubrech, M Sauerbier
BACKGROUND: A stable distal radioulnar joint (DRUJ) is mandatory for the rotation and load transmission in the forearm and wrist. Salvage procedures such as the Darrach operation, Bowers arthroplasty, and the Kapandji-Sauvé procedure include the potential risk of dynamic radioulnar instability and impingement, despite stabilizing techniques addressing the soft tissues. PROSTHESES: In an attempt to stabilize the distal forearm mechanically following ulnar head resection, various endoprostheses have been developed to replace the ulnar head...
May 24, 2018: Der Orthopäde
Takuma Wakasugi, Ritsuro Shirasaka, Koji Fujita
The Sauve-Kapandji (SK) procedure for distal radioulnar joint osteoarthritis have complications including pain over the proximal ulnar stump, nonunion of the fused distal radioulnar joint, and less frequently, insufficiency fracture of the distal radius. We report a case of insufficiency fracture of the radial diaphysis as a rare complication of the SK procedure.
June 2018: Journal of Hand Surgery Asian-Pacific Volume
Jung-Pan Wang, Hui-Kuang Huang, Duretti Fufa
Persistent distal radioulnar joint (DRUJ) instability after internal fixation of distal radius fractures can be managed with soft tissue or bony stabilization and prolonged immobilization. However, these strategies limit postoperative motion. To address this limitation, we report our technique of indirect ulna shortening by radial distraction followed by early mobilization and provide a case example. We use this technique in cases of persistent DRUJ instability during standard volar plating of distal radius fractures...
May 2018: Journal of Hand Surgery
Robin N Kamal, Fraser Leversedge, David S Ruch, Suhail K Mithani, Ilvy H F Cotterell, Marc J Richard
PURPOSE: This study defines the sigmoid notch view of the distal radius. Specifically, we tested the null hypothesis that there is no relationship between the subchondral stripe of bone seen on a sigmoid notch view of the distal radius and the articular surface of the sigmoid notch. METHODS: We used 44 wrist specimens for anatomic and fluoroscopic analysis. We measured the articular depth of the sigmoid notch from its deepest point and classified the shape of the sigmoid notch...
April 18, 2018: Journal of Hand Surgery
Zachary C Lum, Eric G Huish, Marc A Trzeciak
Background: When approaching radial head and neck fractures, the decision for ORIF, resection, or arthroplasty is often performed intraoperatively. Factors that contribute include ligamentous and bony stability, cartilage injury, mechanical alignment as well as patient factors. Recent data has suggested conventional methods may not be sufficiently sensitive in detecting Essex Lopresti injuries. Here we describe an intraoperative technique that could objectively assess proximal radio-ulnar stability with subsequent disruption of the ligamentous structures...
March 2018: Journal of Orthopaedics
Femke Nawijn, Benjamin Lucas Emmink, Jort Keizer, Willem-Maarten Bosman
A 10-year-old girl presented to the emergency department with proximal radioulnar translocation and radial head fracture, after fall onto an outstretched hand. Open reduction was used to reduce and stabilise the elbow joint after which the radial head was fixated by Kirschner wires. Three months after surgery, full range of motion was regained and union of the radial head was achieved. Proximal radioulnar translocation is a rare injury which is often missed on initial radiographs. Persistent restriction of forearm rotation with seemingly normal elbow configuration must trigger to take a closer look at the relationship between the ulna, radius and distal humerus...
March 28, 2018: BMJ Case Reports
Marcio Aurelio Aita, Fabio Lucas Rodrigues, Rodrigo Montemor Bernardo, Daniel Rebolledo, Danilo Barronovo, Gustavo Mantovanni Ruggiero
Background:  We aim to measure the quality of life and clinical and functional outcomes of a patient who had undergone ligament reconstruction of the forearm interosseous membrane, using brachioradialis tendon more ulna distraction osteogenesis in treatment with multiple cartilaginous exostosis. Case Description:  We present a 11-year-old boy with congenital deformity in his right, dominant forearm,Type IIb by Masada classification. Distraction of the ulna, resection of exostosis, and reconstruction of the distal part of the interosseous membrane was performed...
April 2018: Journal of Wrist Surgery
Flavien Mauler, Jean-Yves Beaulieu
Background  Variations in morphology of the carpal bones have been described. Their implication in wrist disease and specific kinematic features has been recognized, and a better knowledge of these variations is essential. Questions/Purpose  To radiographically determine any association between the morphological variations of the distal radioulnar joint (DRUJ) and the lunate bone. Materials and Methods  Radiographs of 100 wrists of patients presenting to the emergency department with wrist pain and referred to our outpatient clinic were retrospectively reviewed for DRUJ inclination, ulnar variance, and radiocarpal and midcarpal morphology of the lunate...
April 2018: Journal of Wrist Surgery
Akio Minami, Yukinobu Kamiya, Yasuaki Tojo, Satoko Matsumoto Harmon, Kota Suda
BACKGROUND: The Sauvé-Kapandji (SK) procedure is one of several surgical options in the treatment of distal radioulnar disorders by osteoarthritis (OA) and rheumatoid arthritis (RA). While satisfactory postoperative clinical results were obtained in most cases, instability of the proximal ulnar stump and radioulnar convergence are the most common complications. Minami et al. have developed a modification of the SK procedure that maintains the transverse diameter of the distal radioulnar joint and stabilizes the proximal ulnar stump, using a half-slip of the extensor carpi ulnaris tendon...
May 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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