gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Our results with distal radioulnar joint hemiarthroplasty

Meeting Abstract

  • presenting/speaker Istvan Zoltan Rigo - Ostfold Hospital Trust, Dep. of Orthopaedics, Gralum, Norway
  • Asgeir Amundsen - Ostfold Hospital Trust, Dep. of Orthopaedics, Gralum, Norway
  • Preben Olsson Dovland - Ostfold Hospital Trust, Dep. of Orthopaedics, Gralum, Norway
  • Balazs Simon - Ostfold Hospital Trust, Dep. of Orthopaedics, Gralum, Norway
  • Jens Holthusen - Ostfold Hospital Trust, Dep. of Orthopaedics, Gralum, Norway
  • Jan-Ragnar Haugstvedt - Ostfold Hospital Trust, Dep. of Orthopaedics, Gralum, Norway

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-663

doi: 10.3205/19ifssh1403, urn:nbn:de:0183-19ifssh14035

Veröffentlicht: 6. Februar 2020

© 2020 Rigo et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives/Interrogation: Painful distal radioulnar joint (DRUJ) can be a consequence of distal radial fracture, ulnar impaction syndrome or general inflammation disease. Intact DRUJ is a prerequisite for normal load transfer from the hand to the forearm under heavy lift. After resection of distal ulna (Darrach procedure), which is the standard treatment in many centres for painful DRUJ, the biomechanics will be negatively changed, patients experience often painful impingement between the ulnar stump and the radius and instability of the forearm. Ulnar head replacement can reconstruct the normal load transfer and publications show good results up to 11 years follow up. Our intention is to show our short term results with uHead ulnar head prosthesis.

Methods: This implant consists of an uncemented stem and a head, both made of cobalt-chrome. The head includes two holes for placement of stiches against the TFCC and the ECU subsheath.

Nine patients were operated with uHead implant at our hospital between 2014 and 2017, all women, mean age of 66 years (range 48-82), 6 in the right hand. The diagnosis was osteoarthritis of the DRUJ without instability; 8 distal radius sequels and one psoriatic arthritis. Two patients received partial and one total wrist fusion at the same time, one operated with total wrist fusion earlier. The follow up was 9 (5-14) months.

Results and Conclusions: The mean pro-supinasjon ROM increased from 149 (80% of the other hand) to 163 degrees (92%). Grip strength increased from 10.1 (46%) to 12.4 kg (62%).

VAS pain score decreased from 6.4 to 2.7, the Quick DASH score from 66.1 to 37.1 and the PRWHE from 73.4 to 37.6. All of the patients were satisfied with the results. We observed two complications, one irritation of the dorsal branch of the ulnar nerve and one loosening of the head from the stem. The latest was reoperated 3 days later; with removal of the stabilising stiches between the head and the soft tissues the problem became resolved. Since then we have dropped placement of these stiches.

Our results are promising, comparable with other published series. UHead implant seems to be a good solution to DRUJ arthritis without instability, however this well-documented implant is retrieved from the marked after fusion of the producer to a bigger company.