Ulnar Head Replacement: 21 Cases; Mean Follow-Up, 7.5 Years

Area of Science:

• Orthopedic surgery
• Hand surgery
• Arthroplasty

Background:

• Distal radioulnar joint (DRUJ) disorders can significantly impact upper extremity function.
• Ulnar head prosthesis arthroplasty is a treatment option for specific DRUJ conditions.

Purpose of the Study:

• To evaluate the clinical and radiographic outcomes of the Herbert ulnar head prosthesis.
• To assess long-term results after a mean follow-up of 7.5 years.

Main Methods:

• 22 Herbert ulnar head prosthesis arthroplasties were performed between 2000 and 2011.
• Follow-up included clinical examination, standardized questionnaires (DASH, PRWE, Mayo wrist score), and radiographic assessment.
• Pain and satisfaction were measured using visual analog scales (VAS), alongside range of motion and grip strength.

Main Results:

• Supination significantly improved from 55° to 70°; other range of motion was unaffected.
• Mean grip strength was 25 kg in operated wrists (contralateral: 31 kg).
• Mean VAS pain was 2.9 during activity and 1.7 at rest, with a satisfaction VAS of 8.9. No radiographic loosening was observed. One patient required reoperation for instability but pain resolved.

Conclusions:

• The Herbert ulnar head prosthesis demonstrates safety and satisfactory midterm results for selected DRUJ disorders.
• Understanding the performance of ulnar head arthroplasty can inform surgical decision-making for DRUJ conditions.