The Evaluation and Treatment of the Arthritic Distal Radioulnar Joint

Distal radioulnar joint (DRUJ) arthritis presents a challenging problem. Surgical interventions include resection arthroplasties, such as the Darrach procedure and hemiresection arthroplasty, the Sauve-Kapandji procedure, and more recently prosthetic replacement for either the ulnar head or the entire DRUJ. Resection arthroplasties have been associated with complications, including instability and radioulnar convergence. The prosthetic replacements have been designed in an attempt to restore more normal DRUJ kinematics. This paper provides a review of the anatomy and biomechanics of the DRUJ and discusses the outcomes of the available surgical options for symptomatic DRUJ arthritis. The arthritic distal radioulnar joint (DRUJ) is a difficult problem. Many of the surgical interventions developed for this condition are associated with complications,such as instability and radioulnar convergence. Recently, prosthetic replacement of either the ulnar head or the entire DRUJ has been advocated in order to better restore the kinematics of the joint. A review of the anatomy and biomechanics of the DRUJ and a discussion of the numerous surgical options and their outcomes is provided.