gms | German Medical Science

Objectives/Interrogation: Disturbances of the distal radioulnar joint (ARUD) are relatively common and its instability presents a diagnostic and therapeutic challenge due to the biomechanical complexity of this joint. In cases without arthrosis, where direct repair of CFCT is no longer possible, reconstructive techniques are the most indicated, but in general, they do not present satisfactory results.

Objective: to evaluate the effectiveness of extensor retinaculum in the treatment of chronic distal radioulnar joint (DRUJ) instability through clinical and radiographic results. Is it effective?

Methods: The casuistry consists of ten cases, three of which are female. The mean age was 41.75 years and the mean time between the trauma and the surgical procedure was 13 months. In the surgical technique, after the reduction and fixation of the (DRUJ), the extensor retinaculum is used, which is disinserted from its ulnar insertion, maintaining its support base in the third extensor compartment. Divided into two tapes that are traced and fixed to the ulna with metal anchors of 2.7mm under maximum tension. The kirschner wire and the immobilization are maintained for 6 weeks.

Results: Joint stability occurred in the postoperative period in 100% of the cases. There was improved DASH after surgery for all patients from 74.6 to 38.3. The EVA presented a mean decrease from 8.5 to 4.0, in the active postoperative period and 1.0 at rest. All joint movements evaluated were improved. There was a mean palmar grip strength gain from 13.5kgf to 19.0kgf. There was a statistically significant improvement of all these parameters, with the exception of joint range of motion. In the radiographic evaluation, in all cases, the DRUJ congruence was obtained in the immediate postoperative period.

Conclusion: The technique of using the extensor retinaculum to stabilize chronic lesions of the distal radioulnar joint is effective and obtains good clinical and radiographic results.