Distal radioulnar joint arthroplasty: the hemiresection-interposition technique

The hemiresection-interposition technique for distal radioulnar joint arthroplasty was developed from anatomic studies that indicated the importance of preserving the functional elements of the ulnocarpal ligament complex. The technique has been previously described. My experience with 38 patients who were followed for an average of 2 1/2 years shows that the procedure is most valuable for patients with rheumatoid arthritis (85% had stable, painless pronation averaging 84 degrees and supination of 77 degrees, while 15% had mild pain and pronation of 70 degrees and supination of 75 degrees). It is also valuable for patients with degenerative or trauma-induced arthritis (100% had painless rotation-pronation averaging 80 degrees and supination of 80 degrees). A modified procedure is useful for patients with ulnocarpal impingement syndrome where the Milch shortening osteotomy may not succeed because of radioulnar incongruity.