Skip to main content
Log in

Reconstruction for DRUJ Instability

  • Published:
HAND

Abstract

The skeletal architecture of the DRUJ provides minimal inherent stability, as the sigmoid notch is shallow and its radius of curvature is 50% greater than that of the ulnar head [Af Ekenstam F, Hagert CG. Anatomical studies on the geometry and stability of the distal radio ulnar joint. Scand J Plast Reconstr Surg 1985;19(1):17–25]. Due to its incongruent articulation, the DRUJ relies strongly on the surrounding soft tissues for stability. The triangular fibrocartilage complex (TFCC) is generally accepted as the major soft tissue stabilizer of the DRUJ of which the volar and dorsal radioulnar ligaments are the primary components. Restoration of the radioulnar ligaments offers the best possibility to restore the normal DRUJ primary constraints and kinematics. This article presents an update of the procedure developed by the senior author that anatomically reconstructs the palmar and dorsal radioulnar ligaments at their anatomic origins and insertions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6

Similar content being viewed by others

References

  1. Adams BD, Berger RA. An anatomic reconstruction of the distal radioulnar ligaments for posttraumatic distal radioulnar joint instability. J Hand Surg [Am] 2002;27(2):243–51.

    Article  Google Scholar 

  2. Adams BD, Samani JE, Holley KA. Triangular fibrocartilage injury: a laboratory model. J Hand Surg [Am] 1996;21(2):189–93.

    Article  CAS  Google Scholar 

  3. Af Ekenstam F, Hagert CG. Anatomical studies on the geometry and stability of the distal radio ulnar joint. Scand J Plast Reconstr Surg 1985;19(1):17–25.

    CAS  PubMed  Google Scholar 

  4. Breen TF, Jupiter J. Tenodesis of the chronically unstable distal ulna. Hand Clin 1991;7(2):355–63.

    CAS  PubMed  Google Scholar 

  5. Fulkerson JP, Watson HK. Congenital anterior subluxation of the distal ulna. A case report. Clin Orthop 1978;131:179–82.

    PubMed  Google Scholar 

  6. Hermansdorfer JD, Kleinman WB. Management of chronic peripheral tears of the triangular fibrocartilage complex. J Hand Surg [Am] 1991;16(2):340–6.

    Article  CAS  Google Scholar 

  7. Hui FC, Linscheid RL. Ulnotriquetral augmentation tenodesis: a reconstructive procedure for dorsal subluxation of the distal radioulnar joint. J Hand Surg [Am] 1982;7(3):230–6.

    CAS  Google Scholar 

  8. Johnson Jones K, Sanders WE. Posttraumatic radioulnar instability: treatment by anatomic reconstruction of the volar and dorsal radioulnar ligaments. Orthop Trans 1995–1996;19:832.

    Google Scholar 

  9. Kihara H, Short WH, Werner FW, Fortino MD, Palmer AK. The stabilizing mechanism of the distal radioulnar joint during pronation and supination. J Hand Surg [Am] 1995;20(6):930–6.

    Article  CAS  Google Scholar 

  10. Petersen MS, Adams BD. Biomechanical evaluation of distal radioulnar reconstructions. J Hand Surg [Am] 1993;18(2):328–34.

    Article  CAS  Google Scholar 

  11. Scheker LR, Belliappa PP, Acosta R, German OS, et al. Reconstruction of the dorsal ligament of the triangular fibrocartilage complex. J Hand Surg [Br] 1994;19(3):310–8.

    Article  CAS  Google Scholar 

  12. Sennwald GR, Lauterburg M, Zdravkovic V. A new technique of reattachment after traumatic avulsion of the TFCC at its ulnar insertion. J Hand Surg [Br] 1995;20(2):178–84.

    Article  CAS  Google Scholar 

  13. Stuart PR, Berger RA, Linscheid RL, An KN. The dorsopalmar stability of the distal radioulnar joint. J Hand Surg [Am] 2000;25(4):689–99.

    Article  CAS  Google Scholar 

  14. Tsai TM, Stilwell JH. Repair of chronic subluxation of the distal radioulnar joint (ulnar dorsal) using flexor carpi ulnaris tendon. J Hand Surg [Br] 1984;9(3):289–94.

    Article  CAS  Google Scholar 

  15. Ward LD, Ambrose CG, Masson MV, Levaro F. The role of the distal radioulnar ligaments, interosseous membrane, and joint capsule in distal radioulnar joint stability. J Hand Surg [Am] 2000;25(2):341–51.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Brian D. Adams.

About this article

Cite this article

Lawler, E., Adams, B.D. Reconstruction for DRUJ Instability. HAND 2, 123–126 (2007). https://doi.org/10.1007/s11552-007-9034-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11552-007-9034-6

Keywords

Navigation