Instability of the distal radioulnar joint (DRUJ): a description of the problem and own experience

Introduction. The distal radioulnar joint (DRUJ) is important for rotation of the forearm and stability of the ulnar wrist. Any DRUJ injury can cause limitation of the range of motion, decreased strength, pain, and instability. This paper deals with DRUJ instability, and reviews treatment methods and outcome. Disturbances in DRUJ stability result from bone damage, TFCC and ligament injuries, and/or other soft tissue deficiencies (capsule, tendon). Instability due to injury may be acute or chronic in nature. Most acute cases are best treated conservatively. Chronic problems resulting in disability may require surgical treatment. Material and methods. We studied 7 patients (age 23-55) with DRUJ instability, operated in our Department between 2000 and 2004. The patients were qualified for surgery based on a clinical examination supported by imaging techniques. All were traumatic cases, and three had a history of distal radius fracture. Different operative procedures were used due to the variety of clinical presentations: extraarticular ligament reconstruction acc. to Bunnel-Boys, anatomic ligament reconstruction with PL acc. to Adams, restabilization of TFCC, retinacular reconstruction, and capsular duplication. Results. Pain was significantly decreased in all patients. The range of motion postoperatively did not differ compared to preoperative findings. DRUJ stability was restored in all cases. Conclusions. DRUJ instability can result in significant disability. In such cases surgical treatment restores stability and decreases symptoms. Return to preinjury activities is possible following treatment.