Arthroscopic Assisted Distal Radial Ulnar Joint Reconstruction Using a Modified Anatomic Ligament Reconstruction

Distal radioulnar joint (DRUJ) instability is a complex pathology that typically occurs due to injury of the triangular fibrocartilage complex. In the acute setting, repair is often successful. However, in the chronic setting or after a prior failed repair, reconstructive methods aim to improve stability using an extrinsic radioulnar soft tissue link. Traditional surgical techniques are technically demanding and require a broad exposure, compromising extrinsic stabilizers. Modifications to these methods using arthroscopy facilitate preservation of ulnocarpal and DRUJ secondary stabilizers, while providing excellent visualization for anatomic passage of the graft and placement of the foveal bone tunnel. We describe a simple and effective arthroscopic reconstruction method for restoring and reinforcing the native anatomy of the critical stabilizers of the DRUJ.