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Ulnar head replacement.

Timothy J Herbert¹, Joerg van Schoonhoven

¹St Lukes Hospital Hand Unit, Sydney, New South Wales, Australia. interfix@compuserve.com

Techniques in Hand & Upper Extremity Surgery

|June 1, 2007

Summary

The Herbert ulnar head prosthesis effectively restores forearm rotation and function after distal radioulnar joint surgery. This modern implant shows no signs of medium to long-term failure, offering a viable alternative to traditional procedures.

Area of Science:

Orthopedic surgery
Biomechanics
Materials science

Background:

Increasing awareness of distal radioulnar joint (DRUJ) anatomy and biomechanics.
Limitations of traditional "excision arthroplasty" in restoring forearm rotation at the expense of stability.
Historical issues with early ulnar head implants, such as the Swanson silicone prosthesis.

Purpose of the Study:

To evaluate the efficacy and durability of the Herbert ulnar head prosthesis.
To discuss current indications, contraindications, surgical techniques, rehabilitation, and outcomes for ulnar head replacement.
To present prosthetic replacement as an alternative to traditional DRUJ surgeries.

Main Methods:

Review of clinical experience with the Herbert ulnar head prosthesis over 10 years.

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Analysis of prosthesis material performance (ceramic head, titanium stem) under functional loads.

Comparison with traditional procedures like Darrach and Sauve-Kapandji.

Main Results:

The Herbert prosthesis successfully restores forearm function after ulnar head excision.
The ceramic and titanium materials show no medium to long-term failure with normal use.
Growing acceptance of ulnar head prosthesis as a viable surgical option.

Conclusions:

The Herbert ulnar head prosthesis is a safe and effective option for managing DRUJ disorders.
Modern prosthetic materials offer improved durability compared to earlier designs.
Ulnar head replacement is a favorable alternative to excision arthroplasty for select patients.