Long-term results of resection of the distal ulna for post-traumatic conditions

Sixty-two patients underwent resection of the distal ulna because of pain or limited motion after wrist trauma. The median length of resection was 23 mm. Injury to the distal radioulnar joint occurred primarily during fractures of the distal radius. Followup time averaged 87 months. The primary surgical indication was pain, but some procedures were performed in an effort to increase motion. All patients improved after surgery. Three patients had residual pain, 25 had mild pain, and 34 had no pain. Supination was greatly improved, with only modest improvement in other wrist motions. Four patients developed ulnar translation of the carpus (from 1 to 3 mm). Pseudoarticulation and ulnar regrowth of the carpus were noted, but neither pseudoarticulation nor regrowth was clinically symptomatic. Grip strength improved significantly after surgery, the average from 45.3 to 78.9% of the unaffected wrist. The presence or absence of radiocarpal arthritis preoperatively had no significant effect on the patients' estimates of results. Overall, 51 patients (82%) had satisfactory results. The primary gains were pain relief, increased supination, and increased strength.