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Chronic volar distal radioulnar joint instability: joint capsular plication to restore function
Kelly Johnston1, D'Arcy Durand, Kevin A Hildebrand
1University of Calgary and the Calgary Health Region, Calgary, Alta.
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|April 29, 2009
Summary
This study introduces a new surgical technique for treating volar distal radioulnar joint (DRUJ) instability. The capsular plication procedure showed promising results, with most patients experiencing pain and instability relief.
Area of Science:
- Orthopedic Surgery
- Upper Extremity Surgery
- Wrist Biomechanics
Background:
- Volar instability of the distal radioulnar joint (DRUJ) is an uncommon condition with limited documented treatment options.
- Existing literature offers scarce information on managing DRUJ volar instability.
Purpose of the Study:
- To introduce and describe a novel surgical procedure for treating volar distal radioulnar joint (DRUJ) instability.
- To evaluate the clinical outcomes of patients undergoing this unique capsular plication repair for DRUJ instability.
Main Methods:
- A retrospective case series involving 6 patients treated with volar and dorsal capsular plication for DRUJ instability.
- Assessment included range of motion, grip strength, radiographic evaluation, and patient-reported outcomes (DASH, PRWE) at minimum 1-year follow-up.
Main Results:
- Five out of six patients achieved resolution of pain and instability symptoms following the procedure.
- Postoperative assessments revealed functional outcomes with average grip strength at 83% of the uninjured side and notable patient-reported outcome scores.
- Minor complications included transient ulnar neuropathy and heterotopic ossification in one patient each.
Conclusions:
- Joint capsular plication represents a novel and less elaborate surgical approach for DRUJ instability, avoiding the need for tendon grafts and bone tunnels.
- The described capsular plication technique demonstrates promising outcomes for managing volar DRUJ instability, with positive results observed at an average follow-up of 16.5 months.
