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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

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Reconstruction of distal oblique bundle of the interosseous membrane of the forearm by percutaneous ligamentoplasty

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  • presenting/speaker Belén García-Medrano - Hand and Microsurgery, HM Montepríncipe, Madrid, Spain
  • Beatriz Fernández Bran - Hospital Povisa, Pontevedra, Spain
  • Fernando Polo Simón - Hand and Microsurgery, HM Montepríncipe, Madrid, Spain
  • Ricardo Kaempf De Oliveira - Hospital Mae De Deus, Porto Alegre, Brazil
  • Mario Gil De Rozas - HM Montepríncipe, Madrid, Spain
  • Pedro J. Delgado Serrano - Hand and Microsurgery, HM Montepríncipe, Madrid, Spain

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. DocIFSSH19-1489

doi: 10.3205/19ifssh1352, urn:nbn:de:0183-19ifssh13521

Published: February 6, 2020

© 2020 García-Medrano et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Describe indications, technique and results of the reconstruction of the distal oblique bundle (DOB) for longitudinal instability of the distal radioulnar joint (DRUJ) of the wrist.

Methods: 5 patients with DRUJ instability in the period between January 2016 and June 2018. The indication for surgery was pain and loss of pronosupination of the forearm. All cases had a previous radial head fracture. In 4 of the 5 cases they presented partial lesions of the interosseous membrane verified by MRI and ultrasound of the forearm.

All the cases were operated according to the technique described by Brink et al: percutaneous ligamentoplasty with autologous palmaris longus, crossing from radius and fixing on ulnar bone with an interferential screw. Pre-operative and postoperative clinical and radiological parameters were evaluated. The mean follow-up was 14 (3-26) months.

Results and Conclusions: The average age was 26.3 (15-32) years and all were male. In 100% pain disappeared and they recovered the complete arch of movement, without signs of instability. There were no recurrences or new necessary surgeries.

The DOB reconstruction indications are still under debate. In our experience this plasty is a useful technique in patients with longitudinal radio-ulnar instability, sequela of an injury in radial head and longitudinal stabilizers of the forearm. Bigger series with longer follow-up are needed to be able to verify these results.