Instability and Arthritis of the Distal Radioulnar Joint: A Critical Analysis Review

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Musculoskeletal Pathologies

Background:

• Distal radioulnar joint (DRUJ) pathology, including arthritis and instability, is common.
• These conditions can occur independently or as part of complex multifactorial processes.

Purpose of the Study:

• To outline current treatment strategies for distal radioulnar joint (DRUJ) arthritis and instability.
• To discuss the indications and outcomes of various surgical interventions for DRUJ pathology.

Main Methods:

• Review of nonoperative management for acute DRUJ injuries and early arthritis.
• Discussion of surgical techniques including native ligament repair, anatomical reconstruction, Darrach resection, Sauve-Kapandji procedure, and hemiarthroplasty.
• Consideration of DRUJ arthroplasty as a salvage procedure.

Main Results:

• Nonoperative treatment, including immobilization, rest, corticosteroids, and NSAIDs, is effective for many acute injuries and early arthritis.
• Surgical treatment is indicated for instability refractory to nonoperative measures.
• Various surgical procedures offer different solutions for advanced arthritis, with outcomes varying based on technique and patient selection.

Conclusions:

• Treatment for DRUJ arthritis and instability should be tailored to the specific condition and patient.
• Native ligament repair or reconstruction is preferred for instability when possible.
• Surgical options for advanced arthritis range from resection to joint replacement, with arthroplasty reserved for salvage situations.