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. 2023 Aug 17;13(6):528-533.
doi: 10.1055/s-0043-1771341. eCollection 2024 Dec.

Hemiresection Capsuloretinacular Interposition Arthroplasty for Distal Radioulnar Joint Osteoarthritis

Hideo Hasegawa  1 , Shohei Omokawa  1 , Kenji Kawamura  1 , Yasuhito Tanaka  1
Affiliations

Hemiresection Capsuloretinacular Interposition Arthroplasty for Distal Radioulnar Joint Osteoarthritis

Hideo Hasegawa et al. J Wrist Surg. .

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: Hemiresection Interposition Arthroplasty; distal radioulnar joint; triangular fibrocartilage complex.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
The extensor retinaculum flap is lifted up with the ulnar side serving as the base. R, the extensor retinaculum.
Fig. 2
Fig. 2
The head of the ulna where the cartilage damage is seen is resected down to the subchondral bone. D, the dorsal joint capsule of the distal radioulnar joint; R, the extensor retinaculum.
Fig. 3
Fig. 3
The flap is sutured to the ulnar side of the extensor carpi ulnaris tendon.
Fig. 4
Fig. 4
The postoperative radioulnar distance was defined as the minimum distance between the sigmoid notch of the radius and the head of the ulna.
See this image and copyright information in PMC

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