Distal radioulnar joint arthroplasty: the hemiresection-interposition technique

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery

Background:

• Distal radioulnar joint (DRUJ) instability and pain significantly impair wrist function.
• Preservation of the ulnocarpal ligament complex is anatomically crucial for DRUJ stability.
• Existing arthroplasty techniques may not adequately address all etiologies of DRUJ dysfunction.

Purpose of the Study:

• To evaluate the efficacy of the hemiresection-interposition technique for distal radioulnar joint arthroplasty.
• To assess the functional outcomes in patients with various types of arthritis affecting the DRUJ.
• To determine the applicability of a modified technique for specific complex cases.

Main Methods:

• Retrospective review of 38 patients undergoing hemiresection-interposition DRUJ arthroplasty.
• Average follow-up of 2.5 years.
• Assessment of pain, range of motion (pronation/supination), and stability.

Main Results:

• Rheumatoid Arthritis: 85% achieved stable, painless pronation (84°) and supination (77°); 15% experienced mild pain with reduced motion.
• Degenerative/Trauma Arthritis: 100% reported painless rotation (pronation 80°, supination 80°).
• Modified technique showed utility in cases with radioulnar incongruity, potentially outperforming Milch osteotomy.

Conclusions:

• The hemiresection-interposition technique is a valuable option for DRUJ arthroplasty, particularly in rheumatoid arthritis.
• The procedure demonstrates high success rates for pain relief and functional restoration in degenerative and trauma-induced arthritis.
• A modified approach offers a solution for complex ulnocarpal impingement syndromes with radioulnar incongruity.