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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
Background Several different triangular fibrocartilage complex (TFCC) tear patterns have been classified through the use of wrist arthroscopy. A tear of the dorsal aspect of the TFCC has been previo...
Diagnosis of subluxation and dislocation of the distal radioulnar joint (DRUJ) is difficult. In order to measure the shift between radius and ulna, we evaluate a method with a custom platform in this ...
Ulnocarpal impaction syndrome occurs mostly in patients with positive ulnar variance. Ulnar-shortening osteotomy is a commonly used method to correct it, but degenerative changes may appear in the dis...
A total of 20 patients scheduled for wrist arthroscopy, all with clinical signs of rupture to the triangular fibrocartilage complex and distal radioulnar joint instability, were tested pre-operatively...
Anatomic Relationships of the Distal and Proximal Radioulnar Joints Articulating Surface Areas and of the Radius and Ulna Bone Volumes - Implications for Biomechanical Studies of the Distal and Proximal Radioulnar Joints and Forearm Bones.
Previous work from this laboratory has evidenced the biomechanical role of forearm osseoligamentous structures in load transfer of applied forces. It has shown that forces transmitted across the dista...
Fractures of the distal radius are one of the most common orthopaedic injuries and are associated with a high complication rate. There is a lack of clinical trials comparing the different ...
This study objectives are to compare the efficacy and safety between surgical excision and manual rupture for dorsal carpal ganglion.The participants with dorsal carpal ganglion will be ra...
The purpose of this study is to determine the relationship between cutaneous functional unit(CFU)recruitment throughout the available active range of motion of a prescribed joint in normal...
This study will determine the effectiveness and safety of dorsal penile nerve block (DPNB) in men undergoing rigid cystoscopy.
The purpose of the study is to determine the optimal surgical approach (ventral versus dorsal) for patients with multi-level cervical spondylotic myelopathy (CSM). There are no establishe...
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.
Arthritis Fibromyalgia Gout Lupus Rheumatic Rheumatology is the medical specialty concerned with the diagnosis and management of disease involving joints, tendons, muscles, ligaments and associated structures (Oxford Medical Diction...
An anesthesiologist (US English) or anaesthetist (British English) is a physician trained in anesthesia and perioperative medicine. Anesthesiologists are physicians who provide medical care to patients in a wide variety of (usually acute) situations. ...