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      Distal Radioulnar Joint Instability

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          Abstract

          Distal radioulnar joint (DRUJ) instability is a common clinical condition but a frequently missed diagnosis. Both surgical and nonsurgical treatments are possible for chronic cases of DRUJ instability. Nonsurgical treatment can be considered as the primary therapy in less active patients, while surgery should be considered to recover bone and ligament injuries if nonsurgical treatment fails to restore forearm stability and function. The appropriate choice of treatment depends on the individual patient and specific derangement of the DRUJ

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          New trends in arthroscopic management of type 1-B TFCC injuries with DRUJ instability.

          A Atzei (2009)
          Advances in radiocarpal and distal radioulnar joint (DRUJ) diagnostic arthroscopy permits a treatment-oriented classification of triangular fibrocartilage complex (TFCC) peripheral tears: 1) repairable distal tears; 2) repairable complete tears; 3) repairable proximal tears; 4) non-repairable tears; and 5) tears associated with DRUJ arthritis. Class 1 tears should be sutured; Class 2 and 3 are associated with DRUJ instability and require TFCC reattachment to the fovea; Class 4 tears need reconstruction using a tendon graft and Class 5 tears require an arthroplasty. Arthroscopic assisted TFCC foveal reattachment is possible through the direct foveal portal, a dedicated DRUJ working portal. Arthroscopic TFCC reconstruction using a tendon graft showed promising results.
          Article 0 comments Cited 27 times – based on 0 reviews     Review now
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            Effects of radial deformity on distal radioulnar joint mechanics.

            Susan Adams (1993)
            A cadaver experiment was performed to study the effects of radial deformity on the kinematics of the distal radioulnar joint and the anatomic configuration of the triangular fibrocartilage. Radial shortening caused the greatest disturbance in kinematics and the most distortion of the triangular fibrocartilage. Decreased radial inclination and dorsal angulation caused intermediate changes. Dorsal displacement produced minimal changes. Radial deformity did not produce distal radioulnar joint dislocation. These results provide biomechanical evidence of an important relationship between radial malunion and persistent symptoms in the distal radioulnar joint.
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              The distal radioulnar ligaments: a biomechanical study.

              Frédéric Schuind, Kai-Nan An, Lawrence Berglund … (1991)
              The mechanical roles of the triangular fibrocartilage have been examined in three experiments. Kinematic analysis by a stereophotogrammetric method revealed that the palmar radioulnar ligament was taut in supination and that the dorsal radioulnar ligament was taut in pronation. In full pronation, the palmar radioulnar ligament decreased to an average of 71% of its length in tension. In full supination, the dorsal radioulnar ligament decreased to an average of 90% of its length. Mechanical testing of the triangular fibrocartilage under axial load disclosed a significant laxity (mean: 10.4 mm), which was decreased in pronation. Transverse loading tests demonstrated that the triangular fibrocartilage is less stiff in neutral forearm rotation. Study of the material properties of the palmar and dorsal parts of the triangular fibrocartilage showed these structures to be strong ligaments with material properties similar to those of the radiocarpal ligaments.
              Article 0 comments Cited 17 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Geriatr Orthop Surg Rehabil
                Journal ID (iso-abbrev): Geriatr Orthop Surg Rehabil
                Journal ID (publisher-id): GOS
                Journal ID (hwp): spgos
                Title: Geriatric Orthopaedic Surgery & Rehabilitation
                Publisher: SAGE Publications (Sage CA: Los Angeles, CA )
                ISSN (Print): 2151-4585
                ISSN (Electronic): 2151-4593
                Publication date (Print and electronic): September 2015
                Publication date (Print): September 2015
                Publication date PMC-release: 1 September 2016
                Volume: 6
                Issue: 3
                Pages: 225-229
                Affiliations
                [1 ]Department of Orthopaedic Surgery, Sina Hospital, School of Medicine, University of Tehran, Tehran, Iran
                [2 ]Department of Orthopaedic Surgery, University of Rochester Medical Center, Rochester, NY, USA
                [3 ]Department of Physical Medicine and Rehabilitation, Aja University of Medical Science, Tehran, Iran
                [4 ]School of Medicine, Qom University of Medical Sciences, Qom, Iran
                Author notes
                [*]John C. Elfar, Department of Orthopaedic Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Box 665, Rochester, NY 14642, USA. Email: john_elfar@ 123456urmc.rochester.edu
                Article
                Publisher ID: 10.1177_2151458515584050
                DOI: 10.1177/2151458515584050
                PMC ID: 4536508
                PubMed ID: 26328241
                SO-VID: 37f78b93-0b08-4331-beab-cb658256ae5a
                Copyright © © The Author(s) 2015
                History
                Categories
                Subject: Reviews

                Keywords: distal radioulnar joint,instability,triangular fibrocartilage complex,surgical management
                Data availability:
                Keywords: distal radioulnar joint, instability, triangular fibrocartilage complex, surgical management

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