Functional Outcomes after Arthroplasty of the Distal Radioulnar Joint and Hand Therapy: A Case Series

Kaiser, Gretchen L.; Bodell, Leonard S.; Berger, Richard A.

doi:10.1197/j.jht.2008.06.002

Cited by 17 publications

(4 citation statements)

References 33 publications

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“…Other types of total DRUJ prostheses have been reported in a single series. 31 In addition, the impingement between the radius and the ulna is a well-known complication of the traditional procedures, such as Darrach and Sauve-Kapandji. 32 This does not occur with total DRUJ replacement.…”

Section: Discussionmentioning

confidence: 99%

Total Joint Arthroplasty of the Distal Radioulnar Joint for Rheumatoid Arthritis

Galvis

Pessa

Scheker

2014

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 99%

Total Joint Arthroplasty of the Distal Radioulnar Joint for Rheumatoid Arthritis

Galvis

Pessa

Scheker

2014

The Journal of Hand Surgery

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“…The clinical outcomes in the nonrevised patients in our study are similar to those reported in other publications with isolated UHR. [15][16][17][18][19][20] Pain, function, and grip strength, all were improved, while motion did not change clinically or statistically significant. Three of our patients had to be revised.…”

Section: Discussionmentioning

confidence: 99%

Ulnar Head or Total Distal Radioulnar Joint Replacement, Isolated and Combined with Total Wrist Arthroplasty: Midterm Results

Gvozdenovic

Boeckstyns²,

Merser

2020

J Wrist Surg

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Purpose Various implants have been described for ulnar head replacement (UHR) or for total replacement of the distal radioulnar joint (DRUJ). Many series are small and few reports on mid- or long-term results. This study is primarily aimed to report on the midterm results after ulnar head only and total DRUJ replacement using the uHead in the treatment of painful disorders of the DRUJ. The secondary aim of the study was to eventually assess the combination of UHR and total wrist arthroplasty (TWA). Materials and Methods We included 20 consecutive patients in whom an UHR with the uHead was performed at our institution between February 2005 and March 2017. There were 6 men and 14 women with mean age of 59 years (range: 36–80 years). The mean follow-up time was 5 years (range: 2–15 years). Data were recorded prospectively before operation and at follow-up examinations and entered in a registry. The patients were followed-up at 3 and 6 weeks and 3, 6, and 12 months postoperatively and thereafter annually. In five cases, the uHead was implanted simultaneously with a Remotion TWA. In four cases, a Remotion TWA had been implanted previously. Kaplan–Meier survival analysis was used to estimate the cumulative probability of remaining free of revision. A nonparametric Wilcoxon's signed-rank test was used for comparing data not normally distributed (qDASH [quick disabilities of the hand, shoulder, and arm] scores), and the paired parametric Student's t-test was used for normally distributed data (pain and visual analogue scale [VAS] scores, range of motion, and grip strength). Significance was set at a p-value of less than 0.05. Results Pain, grip strength, and the function improved significantly. Pain after surgery decreased with 50 points on the VAS score scale of 100, from 66 (mean), preoperatively (range: 16–97) to 16 (mean; range: 0–51), postoperatively, while grip strength nearly doubled from 12 KgF (mean; range: 4–22), before to 21 KgF (mean; range: 6–36), after the surgery. Patients function measured with qDASH scores improved from 56 (mean; range: 36–75), preoperatively to 19 (mean; range: 4–47), postoperatively. Wrist extension, flexion, and ulnar and radial deviation did not change to a clinically or statistically significant extend, neither did supination nor pronation improved after surgery. While three UHRs were revised early because of pain problems and/or unsatisfactory forearm rotation in two cases and infection in one, 17 had an uncomplicated postoperative course and these patients were satisfied with the results of the surgery at all the follow-ups. Due to limited number of cases, the calculation of significance in comparing combined cases with UHR only cases was abandoned. Conclusion Ulnar head arthroplasty (uHead) showed significant improvement in pain, grip strength, and the function of the patients with a painful disability of the DRUJ, without impairment on mobility on the midterm follow-up. The overall implant survival over the time and the complication rate was acceptable.

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“…After an ulnar head endoprosthesis, the patient may be immobilized in a long arm or Muenster style splint [20,37]. Kaiser reports use of a Muenster splint for at least four weeks versus two weeks in the nonrheumatoid population, weaning the splint from 4 to 6 weeks if stable and beginning gentle active motion [37].…”

Section: Rehabilitation Following Druj Surgical Proceduresmentioning

confidence: 99%

Hand Therapy Management of the Rheumatoid Wrist

Pereira¹,

Carlson²

2013

CRR

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It is estimated that rheumatoid arthritis affects 1.3 million adults in the United States. Ninety to ninety-five percent of those patients have wrist involvement. Surgical procedures for the rheumatoid wrist are briefly reviewed. Hand therapy treatment for the surgical and non-surgical patient is then discussed. Special attention is given to the importance of individualized treatment and evidence-based practice.

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Functional Outcomes after Arthroplasty of the Distal Radioulnar Joint and Hand Therapy: A Case Series

Cited by 17 publications

References 33 publications

Total Joint Arthroplasty of the Distal Radioulnar Joint for Rheumatoid Arthritis

Total Joint Arthroplasty of the Distal Radioulnar Joint for Rheumatoid Arthritis

Ulnar Head or Total Distal Radioulnar Joint Replacement, Isolated and Combined with Total Wrist Arthroplasty: Midterm Results

Hand Therapy Management of the Rheumatoid Wrist

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