Dorsal capsular imbrication for dorsal instability of the distal radioulnar joint.
Summary of "Dorsal capsular imbrication for dorsal instability of the distal radioulnar joint."
To stabilize the distal radioulnar joint (DRUJ) by performing dorsal capsular imbrication in patients presenting with dorsal instability. The goal was to reduce pain and prevent the occurrence of posttraumatic arthrosis.
Posttraumatic dorsal instability of the DRUJ with missing block while performing translational activities in the DRUJ or subluxation while actively rotating the forearm. Cases, in which other stabilizing techniques, such as, sutures of the triangular fibrocartilage complex failed.
DRUJ arthrosis, previous surgical interventions to the capsule area of the DRUJ, instabilities due to osseous reasons (malposition or pseudarthrosis) should already have been treated. SURGICAL
Dorsal approach and opening of the 5th extensor compartment to expose the dorsal joint capsule. A longitudinal division of the capsule was performed and sufficient tissue on the radial and ulnar border was retained to ensure a solid suture technique. Then 2 U-shaped sutures using FiberWire suture material were made. Correction of the malposition and repositioning the forearm into supination. Tightening of the prepared capsule sutures and closing of the retinaculum with a resorbable suture. POSTOPERATIVE
Patients wore a long-arm cast with the forearm being in supination for a period of 4 weeks. Following cast removal, patients wore a forearm splint for a period of 4 weeks to limit forearm pronation/supination at 45°. Full load on the wrist was allowed after 12 weeks.
The subjective and functional outcomes of 20 patients having received capsular imbrication using this technique were good and entailed no significant complications. The postoperative DASH was 15.8 points. Of the 20 patients, 17 patients (85 %) had a reduction of pain. Symptoms of DRUJ instability could be reduced in 18 patients (90 %). Pronation/supination of the wrist was not restricted postoperatively.
Handchirurgie Vulpiusklinik, Vulpiusstr. 29, 74906, Bad Rappenau, Deutschland, firstname.lastname@example.org.
This article was published in the following journal.
Name: Operative Orthopadie und Traumatologie
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/23512180
- DOI: http://dx.doi.org/10.1007/s00064-012-0223-2
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Medical and Biotech [MESH] Definitions
The joint that is formed by the distal end of the RADIUS, the articular disc of the distal radioulnar joint, and the proximal row of CARPAL BONES; (SCAPHOID BONE; LUNATE BONE; triquetral bone).
A small protuberance at the dorsal, posterior corner of the wall of the third ventricle, adjacent to the dorsal thalamus and pineal body. It contains the habenular nuclei and is a major part of the epithalamus. (From Lockard, Desk Reference for Neuroscience, 2nd ed, p121)
The thin, horny plates that cover the dorsal surfaces of the distal phalanges of the fingers and toes of primates.
The paired bundles of nerve fibers entering and leaving the spinal cord at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots efferent, comprising the axons of spinal motor and autonomic preganglionic neurons. There are, however, some exceptions to this afferent/efferent rule.
Lack of stability of a joint or joint prosthesis. Factors involved are intra-articular disease and integrity of extra-articular structures such as joint capsule, ligaments, and muscles.