Reconstruction of the posttraumatic unstable distal radioulnar joint

Comparison of Distal Radioulnar Joint Reconstructions Using an Active Joint Motion Simulator

“…32 Muscle transfers have been criticized similarly for difficulty in optimizing the position of advancement and unreliable outcomes. 30 These reconstruction methods were not studied in the current investigation.…”

“…4,14,30 -32 Muscle transfers have been criticized for restricting forearm rotation and having unreliable outcomes. 30 Current biomechanical data confirming the importance of the dorsal and palmar radioulnar ligaments in maintaining DRUJ stability has resulted in several recently described anatomic radioulnar reconstructions. 4,30 Although initial clinical success has been reported with these and other reconstructions, currently only a limited appraisal of the clinical results is available.…”

“…30 Current biomechanical data confirming the importance of the dorsal and palmar radioulnar ligaments in maintaining DRUJ stability has resulted in several recently described anatomic radioulnar reconstructions. 4,30 Although initial clinical success has been reported with these and other reconstructions, currently only a limited appraisal of the clinical results is available. 11,14 Biomechanical comparisons of these reconstructions also are limited.…”

Update on distal radioulnar joint instability

“…If the volar or dorsal lip of the sigmoid notch is incompetent, previous authors have noted that performing a soft-tissue reconstruction may be insufficient, and an opening-wedge osteotomy of the distal part of the radius may be required. 19 When required, this can done either as a first stage of reconstruction, or, although adding to the complexity of the case, in conjunction with a reconstruction of the distal radioulnar ligaments described in the following section.…”

“…26 In another article, of 20 patients (12 with bidirectional instability and eight with unidirectional instability) followed for a minimum of 1 year after the procedure, 18 recovered stability, with an 80% recovery of supination, 84% recovery of pronation, and 88% recovery of grip strength. 19 Although multiple DRUJ reconstruction options are described, there has been sparse research evaluating the ability of these procedures to restore improved joint kinematics and stability. One cadaver study found that, among the options of capsular repair or tendon graft reconstruction, all techniques significantly improved joint kinematics.…”