Ligamentous Reconstruction for Post-traumatic Chronic Instability of Distal Radioulnar Joint
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 6
Abstract
Introduction: Disorders of the distal radioulnar joint (DRUJ) are a common source of ulnar-sided wrist pain. The ulnar side of the wrist has often been likened to the lower back because of the difficulties involved in establishing a specific diagnosis for pain at both sites and therefore in prescribing an effective treatment plan. Aim: The aim of the study was to analyze the clinical and functional results of ligamentous reconstruction in cases of post-traumatic chronic instability of DRUJ. Materials and Methods: Twenty-one cases of chronic instability of dorsal radioulnar joint were included for this prospective study. Bunnell–Boyes procedure and Adam’s procedure were performed. Results: Bunnell–Boyes procedure: Out of 11 patients, 5 patients had excellent wrist score at follow-up, 3 patients had good wrist score, 3 cases of dorsovolar instability for which Bunnell-Boyes procedure was done had only marginal improvement (fair grade) post operatively. Preoperatively, all patients had either fair (or) poor score. Adam’s procedure: Out of 10 patients, 4 patients had excellent wrist scores, 4 patients had good wrist score and 2 cases of old Colle’s fracture the patients had pain during extreme range of pronation and supination movements and recurrence of instability of DRU during follow up (fair grade). All these patients had good stability, pain-free good range of pronation, and supination movement. Conclusion: The goals of chronic instability of DRUJ management are to restore stability and pain-free rotation. Ligamentous reconstruction achieves these goals. The Bunnell–Boyes procedure is ideal for dorsal instability. The Adam’s procedure gives better results for dorsal and volar instability.
Authors and Affiliations
S Marimuthu, G Balasubramanian, Heber Anandan
Keywords
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