The clinical findings show, that reconstruction of distal radioulnar ligaments according to Adams in patients with DRUJ instability and no repairable parts of TFCC, do not allow to re-stabilize the DRUJ in all patients. There is a need for further investigations trying to re-stabilize the DRUJ.
Özkan et al. performed brachioradialis rerouting to restore supination in 5 children between 4 and 14 years with pronation deformity and to restore pronation in 4 children aged 5-9 years with supination deformity. Mean active gain for supination was 81° (40-140°). Active pronation improved from 28 to 49° (30-75°; Özkan et al., J Hand Surg Br 29:263-268, 2004; Özkan et al., J Hand Surg Am 29:22-27, 2004). Between April 2006 and January 2011 we used this technique in 4 patients aged 7-26 years (mean 14 years). Three patients could be followed up. One patient had preoperative a fixed pronation deformity of the forearm in 80° pronation. In this case active range of motion could be improved to 80/30/0° pronation/supination. One patient improved from preoperative 0/0/90° pronation/supination to 30/0/90° postoperatively. In one case no functional improvement of forearm rotation could be achieved in long-term follow-up. No functional loss in forearm rotation to the opposite direction or of the elbow function was observed. Mean follow-up time was 51 months (21-77 months).
This paper describes the surgical technique to reconstruct the distal radioulnar ligaments using the palmaris longus tendon as inaugurated by Brian Adams. A video can be approach online.
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