Distal Radioulnar Joint Instability: Diagnosis and Treatment

Document Type : CURRENT CONCEPTS REVIEW

Authors

1 Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain. 2 Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research – IdiPAZ (La Paz University Hospital – Autonomous University of Madrid), Madrid, Spain

2 Orthopedic Research Center, Department of Orthopedic, Hand, and Microsurgery, St. Marien Stift Medical Campus, Friesoythe, Germany

3 Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, USA. - Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Iran

Abstract

Distal radioulnar joint (DRUJ) instability and triangular fibrocartilage complex (TFCC) tears are more usual than estimated and are frequently overlooked. Diagnosis is often clinical, which can be confirmed using computed tomography (CT) scan and magnetic resonance imaging (MRI). In doubtful cases, bilateral computed tomography in neutral forearm rotation, supination, and pronation should also be performed. Wrist arthroscopy can be diagnostic and therapeutic for ulnar-sided wrist pain. Two systematic reviews showed equivalent outcomes between open and arthroscopic repair of the TFCC. There is scant proof to advise one technique over the other in clinical practice. TFCC repair and reconstruction are contraindicated when there is a bony deformation of the radius or ulna or osteoarthritis of the DRUJ. With the advancement of implant arthroplasty, salvage procedures are less desirable. Constrained distal radioulnar arthroplasty is stable, and the longevity is encouraging. Level of evidence: III

Keywords

References

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The Archives of Bone and Joint Surgery
Volume 10, Issue 1
January 2022
Pages 3-16

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History

  • Receive Date: 27 April 2021
  • Revise Date: 24 May 2021
  • Accept Date: 30 May 2021

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