Functional Effects of the Adams Procedure: A Retrospective Intervention Study

Kootstra, Thomas J.M.; Doesburg, Margriet H. van; Schuurman, Arnold H.

doi:10.1055/s-0038-1660812

Cited by 13 publications

(18 citation statements)

References 20 publications

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“…En los trabajos anteriores, [16][17][18] se describían diferentes tipos de reconstrucción quirúrgica abierta del CFCT. En los últimos años, se han publicado series de casos de cirugía abierta, 19,20 y también series de reconstrucción con cirugía abierta asistida por artroscopia. 21,22 Las técnicas quirúrgicas se esquematizan en la ►Fig.…”

Section: Resultsunclassified

“…2B), y publicó los resultados junto con Berger en 2002. 17 Posteriormente, cuatro equipos de cirujanos realizaron el procedimiento de Adams en sus series, [18][19][20]24 y la mayoría de las técnicas diseñadas posteriormente recogidas en esta revisión sistemática son modificaciones de este procedimiento, 21,22,25,26 que actualmente es el tratamiento patrón oro para la inestabilidad crónica de la ARCD.…”

Section: Discussionunclassified

“…Las 5 series de casos 17-20,24 de reconstrucción con la técnica de Adams (con 9, 14, 16, 74 y 95 pacientes) lograron buenos resultados en el 86% al 100% de los pacientes, con recuperación de la estabilidad de la muñeca (78% a 100%), desaparición del dolor o dolor leve (76% a 89%), y aumento de la fuerza de prensa en las pruebas de funcionalidad. [17][18][19][20]24 Con esta técnica, la mayoría de los autores describieron una disminución de la pronosupinación en comparación con el RDM preoperatorio. 17,19,20 Meyer et al 26 describieron un método de reconstrucción anatómica del CFCT que sólo se diferencia por la fijación de los extremos del injerto tendinoso de la técnica de Adams.…”

Section: Discussionunclassified

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Anatomic Reconstruction of the Triangular Fibrocartilage Complex for the Treatment of Chronic Instability of the Distal Radioulnar Joint. A Systematic Review

Miranda

Lucas

Carratalá

et al. 2021

Revista Iberoamericana de Cirugía de la Mano

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Introduction Peripheral injuries of the triangular fibrocartilage complex (TFCC) can produce pain and instability of the distal radioulnar joint (DRUJ). There are several techniques for the reconstruction of the TFCC. The aim of the present paper was to summarize the tendon plasties of the DRUJ ligaments for the anatomic reconstruction of TFCC, to analyze the surgical techniques, and to evaluate their outcomes. Methods In order to perform a systematic review, we searched in the literature the terms DRUJ instability OR chronic distal radioulnar joint instability OR distal radioulnar tendon plasty. Results In total, 11 articles with level of evidence IV (case series) were retrieved. Most studies achieved good results, with recovery of wrist stability, improvement of the pain, and increase in grip strength in the functionality tests. In the historical evolution of the published series, wrist surgeons tried to perform a more anatomical plasty, with a more stable fixation and less invasive techniques. Conclusion The Adams procedure continues to be a valid and reproducible technique for the treatment of chronic DRUJ instability. If wrist arthroscopy and implants are available and surgeons have been technically trained, the authors recommend an arthroscopy-assisted technique, or, if possible, an all-arthroscopic TFCC reconstruction with implant fixation of the plasty in its anatomical points of insertion. Comparative studies between open and arthroscopic TFCC reconstruction techniques are needed.

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Section: Resultsunclassified

Section: Discussionunclassified

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Anatomic Reconstruction of the Triangular Fibrocartilage Complex for the Treatment of Chronic Instability of the Distal Radioulnar Joint. A Systematic Review

Miranda

Lucas

Carratalá

et al. 2021

Revista Iberoamericana de Cirugía de la Mano

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“…At a mean 1.6 years after surgery, 15 had excellent or good results, while one with a poor outcome owing to residual subluxation improved with a secondary procedure. Kootstra et al. (2018) found that three of 23 Adams–Berger procedures failed at a mean 5 years after the primary operation.…”

Section: Discussionmentioning

confidence: 99%

Outcomes after anatomic reconstruction of the radioulnar ligaments for distal radioulnar joint instability

Frantz

Helsper

Morris

et al. 2020

J Hand Surg Eur Vol

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This retrospective study investigated the clinical outcomes of patients treated for chronic distal radioulnar joint instability with open anatomic reconstruction of the palmar and dorsal radioulnar ligaments. After the midpoint of a tendon graft is anchored at the ulnar fovea, the two graft limbs traverse the distal radioulnar joint. One limb is woven into the palmar wrist capsule and the other is secured to the dorsal wrist capsule and retinaculum to stabilize the joint. Of 30 patients (31 wrists) treated with this technique, 19 were followed longitudinally for a mean of 10 years (range 3–21). In this long-term cohort, there were statistically significant improvements in ulnar-sided wrist pain on the visual analogue scale and in distal radioulnar joint stability on the dorsopalmar stress test. The modified Mayo Wrist Scores were classified as three excellent, 12 good, three fair and one poor. Of the 30 patients studied, failure occurred in four patients, two from graft rupture and two from distal radioulnar joint arthrosis. We conclude that anatomic reconstruction of the palmar and dorsal radioulnar ligaments is an effective treatment for distal radioulnar joint instability and is associated with high satisfaction and durable outcomes. Level of evidence: IV

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“…Historically, surgical repairs of foveal TFCC tears have been performed using a dorsal approach with acceptable clinical outcomes, 7,12,[16][17][18] but the literature has suggested the potential for better functional outcomes via a volar approach as was previously described by Moritomo. 12,[19][20][21] During a dorsal approach to the TFCC, the foveal lesion is challenging to visualize because of the ECU tendon subsheath.…”

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confidence: 99%

Delayed Presentation of Unstable Triangular Fibrocartilage Complex Tears Treated with Volar Foveal Ligament Repair

et al. 2021

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Hypothesis An open volar surgical approach with suture anchor repair of the foveal ligament and temporary pinning of the distal radioulnar joint (DRUJ) is an effective way to treat DRUJ instability associated with chronic foveal tears of the triangular fibrocartilage complex (TFCC). Methods We retrospectively reviewed nine patients with foveal ligament tears of the TFCC and DRUJ instability who underwent open repair of the TFCC using a volar surgical approach, combined with temporary pinning of the DRUJ for 8 weeks. Pain, instability, arc of motion, and functional outcomes scores were evaluated. Results Mean patient age was 40.5 years (range 16.3–56.2). Average time from injury to surgery was 8.4 months (range 2.9–23.3 months). Average final follow-up was 18.9 months from injury (range 12.0–29.3 months), 10.5 months from surgery (range 3.9–18.6 months), and 8.7 months from pin removal (range 1.7–17.2 months). At final follow-up, all patients demonstrated clinically stable DRUJ. Pain scores diminished significantly from pre to final postoperative visits, with averages of 6.8 (range 4.0–9.0) improving to a mean of 0.70 (range 0.0–2.0), respectively. Average postoperative forearm rotation was 71.1 degrees in supination and 76.1 degrees in pronation (average total arc of motion 147.2 degrees, range 90–160 degrees). Average postoperative wrist motion was 68.8 degrees in flexion and 70.6 degrees in extension (average total arc of motion 139.4 degrees, range 110–160 degrees). No patients developed crepitus, recurrent DRUJ instability, or required revision surgery (subsequent to pin removal). Conclusion Volar suture anchor repair of the foveal ligament of the TFCC with DRUJ pinning led to reliable outcomes within this patient group including a stable DRUJ with improved functional outcomes regarding pain, stability, and range of motion in patients with foveal TFCC tears and associated DRUJ instability. These results compare favorably with dorsal repair of the foveal ligament. Level of Incidence This is a Level IV, therapeutic study.

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Functional Effects of the Adams Procedure: A Retrospective Intervention Study

Cited by 13 publications

References 20 publications

Anatomic Reconstruction of the Triangular Fibrocartilage Complex for the Treatment of Chronic Instability of the Distal Radioulnar Joint. A Systematic Review

Anatomic Reconstruction of the Triangular Fibrocartilage Complex for the Treatment of Chronic Instability of the Distal Radioulnar Joint. A Systematic Review

Outcomes after anatomic reconstruction of the radioulnar ligaments for distal radioulnar joint instability

Delayed Presentation of Unstable Triangular Fibrocartilage Complex Tears Treated with Volar Foveal Ligament Repair

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