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Functional Effects of the Adams Procedure: A Retrospective Intervention Study
Thomas J M Kootstra1, Margriet H van Doesburg1, Arnold H Schuurman1
1Department of Plastic Surgery, Universitair Medisch Centrum Utrecht, Universiteit Utrecht, Utrecht, The Netherlands.
Journal of Wrist Surgery
|September 4, 2018
Summary
The Adams procedure for distal radioulnar joint instability shows long-term functional outcomes comparable to a healthy population, despite some decrease in grip strength and range of motion.
Area of Science:
- Orthopedic Surgery
- Hand and Wrist Surgery
- Biomechanics
Background:
- Distal radioulnar joint (DRUJ) injuries lead to wrist pain and swelling.
- The Adams procedure is a surgical technique for DRUJ stabilization.
- Short-term outcomes of the Adams procedure are promising.
Purpose of the Study:
- To evaluate the long-term functional outcomes of the Adams procedure.
- To compare range of motion (ROM) and grip strength of operated wrists to the unaffected side.
Main Methods:
- Follow-up of 22 patients who underwent the Adams procedure.
- Measurement of wrist ROM and grip strength.
- Assessment of functional outcome using Disabilities of the Arm, Shoulder, and Hand (DASH) and Patient-Rated Wrist and Hand Evaluation (PRWHE) scores.
Main Results:
- Mean follow-up of 5.0 years.
- Significant decreases observed in supination, pronation, and grip strength in operated wrists.
- Average postoperative DASH score of 13.1 and PRWHE score of 20.3.
Conclusions:
- The Adams procedure largely restores pronation and supination.
- Clinical outcomes and patient-reported measures suggest comparable upper extremity function to the healthy population post-procedure.
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