The distal radial decompression osteotomy for ulnar impingement syndrome

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Radioulnar Joint Biomechanics

Background:

• Distal radioulnar joint (DRUJ) impingement causes pain and dysfunction.
• Current decompression methods involve radial shaft translation and TFCC detensioning.
• Achieving DRUJ containment often requires radius shortening via osteotomy.

Purpose of the Study:

• To describe a novel distal radial decompression osteotomy technique for the DRUJ.
• To evaluate the method's efficacy in relieving impingement and preserving joint function.
• To assess the impact of the osteotomy on TFCC and DIOM tension.

Main Methods:

• A radial-based wedge osteotomy is performed using a modified Henry approach.
• Osteotomies are precisely placed to avoid iatrogenic impingement.
• Ulnar translation of the radial shaft detensions the distal interosseous membrane (DIOM).
• Closed wedge osteotomy reduces radial inclination, enhancing DRUJ containment.

Main Results:

• The described osteotomy effectively decompresses the DRUJ.
• Painful impingement symptoms are relieved post-operatively.
• The procedure maintains DRUJ function and stability.

Conclusions:

• Distal radial decompression osteotomy is a viable surgical option for DRUJ impingement.
• This technique successfully preserves DRUJ function.
• The procedure does not compromise subsequent surgical interventions in cases of failure.