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J Wrist Surg
DOI: 10.1055/s-0043-1771341
Procedure

Hemiresection Capsuloretinacular Interposition Arthroplasty for Distal Radioulnar Joint Osteoarthritis

Hideo Hasegawa 
1   Department of Orthopaedic, Nara Medical University, Kashihara, Nara, Japan
,
Shohei Omokawa
1   Department of Orthopaedic, Nara Medical University, Kashihara, Nara, Japan
,
Kenji Kawamura
1   Department of Orthopaedic, Nara Medical University, Kashihara, Nara, Japan
,
Yasuhito Tanaka
1   Department of Orthopaedic, Nara Medical University, Kashihara, Nara, Japan
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Abstract

Background Hemiresection interposition arthroplasty (HIA), which can preserve triangular fibrocartilage complex (TFCC) and distal radioulnar joint (DRUJ) function, is one of the surgical options for DRUJ osteoarthritis.

Description of Technique An arcuate vertical incision of approximately 8 cm was made, and the flap, including both the extensor retinaculum and dorsal DRUJ capsule, was wrapped around the resected ulnar head. In cases where the TFCC was torn, repair or reconstruction was also performed.

Patients and Methods Twenty-one wrists in 20 patients with DRUJ osteoarthritis were treated. Patients with rheumatoid arthritis were excluded. Preoperative ulnar variance value averaged 1.8 mm. The average length of follow-up period was 2 years and 10 months. Functional outcomes were evaluated by visual analog scale (VAS) for wrist pain, Disabilities of the Arm, Shoulder, and Hand, Patient-Rated Wrist Evaluation (PRWE), range of wrist and forearm motion (palmar-dorsal flexion and pronation-supination), and grip strength (% of the contralateral value). X-ray parameters (width of the ulnar head, DRUJ distance) were assessed.

Results The postoperative grip strength and range of wrist and forearm motion improved significantly, and VAS for pain and PRWE improved larger than minimum clinical important difference. The DRUJ gap distance was maintained sufficiently in average value of 5.3 mm at the final follow-up.

Conclusion The current modified HIA procedure combined with TFCC repair or reconstruction provides feasible short-term functional outcomes for treatment of patients with DRUJ osteoarthritis regardless of preoperative ulnar variance.

Keywords

distal radioulnar joint - triangular fibrocartilage complex - Hemiresection Interposition Arthroplasty


Publication History

Received: 15 May 2023

Accepted: 28 June 2023

Article published online:
17 August 2023

© 2023. Thieme. All rights reserved.

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