Currently, surgeons assess the stability of the DRUJ manually after fixation of the distal radius to determine which ulnar styloid fractures are associated with instability and require additional intervention.
In our experience, simple fractures of the ulnar neck or ulnar head (with or without a fracture of the tip of the styloid) have a lower tendency toward DRUJ incongruence and instability and are less likely to require operative fixation.
Conventional radiographs can detect the presence of positive ulnar variance, ulceration or cyst formation within the ulnar base of the lunate and/or triquetrum, and joint incongruency of the DRUJ
Because of the mismatch in the radius of curvature of the ulnar head and sigmoid notch, the major contribution to the stability of the DRUJ
is from the surrounding soft tissues.
3) By convention, DRUJ
dislocation is defined on the basis of the final location of the ulna head.
Sigmoid Notch prosthesis, in conjunction with ulnar head replacement, offers an anatomic solution for the restoration of kinematics and stability for primary DRUJ
treatment and salvage.
of patients Loss Of Dorsiflexion (<45 degrees) 0 Loss Of Palmar Flexion (<30 degrees) 11 Loss Of Ulnar Deviation (< 15 degrees) 3 Loss Of Radial Deviation (< 15 degrees) 7 Loss Of Supination (< 50 degrees) 4 Loss Of Pronation (< 50 degrees) 4 Loss Of Circumduction 4 Pain at DRUJ
0 Grip Strength < 60% of opp.
44,47,48) It causes incongruency at the DRUJ
, resulting in loss of forearm rotation.
Osseous or soft tissue injuries about the DRUJ
are relatively common.
22) This technique of resecting several millimeters of bone down to subchondral bone, in order to unload the TFCC and maintain DRUJ
stability, is now being performed arthroscopically.
It is important to leave a peripheral rim of 2 mm of the disc in order to avoid injury to the ulnacarpal ligaments that could lead to DRUJ
Pronation and supination are often painful or limited due to DRUJ