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[Ulnar head prosthesis].

J V Schoonhoven1, T J Herbert, D L Fernandez

  • 1Abteilung I, Klinik für Handchirurgie, Bad Neustadt/Saale. ad@handchirurgie.de

Der Orthopade
|September 26, 2003
PubMed
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This study shows that ulnar head prosthesis implantation significantly improves forearm rotation, grip strength, and reduces pain in patients with distal radioulnar joint (DRUJ) instability or arthritis. Patient satisfaction and bony integration were excellent.

Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery

Background:

  • Distal radioulnar joint (DRUJ) instability and arthritis significantly impair upper extremity function.
  • Previous resection arthroplasties can lead to persistent pain and instability of the distal ulna.

Purpose of the Study:

  • To evaluate the efficacy of ulnar head prosthesis implantation for treating painful instability and arthritis of the DRUJ.
  • To assess functional outcomes, pain reduction, and patient satisfaction following ulnar head prosthesis implantation.

Main Methods:

  • Prospective multicenter study involving 57 patients implanted with ulnar head prostheses between 1995 and 2000.
  • Indications included post-resection arthroplasty instability (35 patients) and DRUJ arthritis (22 patients).
  • Mean follow-up was 38 months, with assessments of range of motion, grip strength, pain, and patient satisfaction.

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Main Results:

  • Significant improvements observed in pronation (63° to 78°) and supination (43° to 76°).
  • Grip strength increased from 51% to 77% of the contralateral limb.
  • Pain scores reduced from 3.6 to 1.7, and patient satisfaction improved from 2.1 to 7.9 (visual analog scale).
  • Excellent bony integration of the prosthesis shaft was noted in all but one case.
  • DRUJ stability was achieved in 54 out of 57 patients.

Conclusions:

  • Ulnar head prosthesis implantation is a reliable salvage procedure for failed distal ulna resections with instability.
  • It offers a viable alternative treatment for arthritically destroyed DRUJ.
  • Adequate soft tissue coverage is crucial for successful prosthesis stabilization and reconstruction.