The Scheker distal radioulnar joint arthroplasty to unravel a virtually unsolvable problem

Failure of the distal radioulnar joint leads to significant dysfunction of the upper limb. Numerous surgical procedures have been suggested to address this problem. In degenerative arthritis, joint instability and ulnar stump dislocation after salvage procedures such as Darrach distal resection or Sauvé-Kapandji distal fusion, an ideal solution may not be available. The ultimate option to restore distal ulna stability in these cases is to fuse the ulna and radius. Obviously, the morbidity of one bone forearm with complete loss of pronation - supination is very high and such a decision is never taken lightly. We present a challenging case series of gross radioulnar arthritis and instability with an acceptable medium-term outcome after semiconstrained Scheker arthroplasty of the distal radioulnar joint. We conclude that in selected cases with unsolvable distal radio-ulnar instability and loss of the DRUJ joint, the Scheker arthroplasty may offer a valuable solution.