Artikel
New technique for reconstruction of DRUJ in chronic instability without arthrosis
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Autoren
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Gustavo Pacheco Martins Ferreira
- Hospital Maria Amélia Lins, Belo Horizonte, Brazil
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Marcella Rodrigues Costa
- Hospital Madre Teresa, Belo Horizonte, Brazil
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Haroldo Oliveira De Freitas Junior
- Hospital da Unimed, Belo Horizonte, Brazil
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Werlley Meira De Oliveira
- Hospital Luxemburgo, Belo Horizonte, Brazil
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Ubiratan Brum De Castro
- Hospital das Clínicas, Belo Horizonte, Brazil
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Marco Antônio Percope De Andrade
- Federal University of Minas Gerais, Belo Horizonte, Brazil
| Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objectives/Interrogation: Disorders of the distal radioulnar joint (DRUJ) of different etiologies are relatively common and can severely affect wrist and forearm function. Acute lesions, if unidentified and treated, may evolve with chronic pain and instability, or degenerative disease in more advanced stages. Due to local bone characteristics, stability is mainly given by the soft tissues, among which the triangular fibrocartilage complex (TFCC) is the main structure. Restoration of DRUJ stability is the goal of treatment and the reconstructions constitute the main group when treating chronic non-arthrosic lesions.
The objective of this paper is to describe a new technique of tenoplasty using a strip of flexor carpi ulnaris (FCU) tendon, for anatomical reconstruction of the DRUJ.
Methods: Five fresh cadavers without signs of lesions or previous surgeries in the upper limbs were selected and the surgical technique was applied to both wrists, totaling 10 reproductions performed by the same hand surgeon. Photographs and computerized figures were presented detailing the most important points of each steps of technique.
Results and Conclusions: The technique of this study presents several advantages when compared to the procedures already described in the literature, since it constitutes a reconstruction of the TFCC that tries to reproduce the anatomy closer to the normal, respecting the ligament origin and insertion points. This allows gain of stability in the sagittal and coronal plane, without limiting movement of prono-supination. Other theoretical advantages of the study include performing only two bone tunnels, with reduced risk of iatrogenic fracture; maintaining a constant tension of the graft, without loosening over time characterizing a dynamic tenoplasty; conservation of the primary function of the FCU; and small need for dissection and short time to perform.
The technique described is suitable for the stability restoration of the DRUJ in cadavers, with technical advantages over other described procedures, being a good alternative for the treatment of chronic instabilities of DRUJ without arthrosis.
