Indications for Distal Radioulnar Arthroplasty: Report on Three Clinical Cases

Abstract

Distal radioulnar arthroplasty is an attractive solution for treating various pathological conditions of the distal radioulnar joint because it allows restoration of stability, load transmission and function. The main indications are: radioulnar impingement after partial or complete resection of the distal ulna; and degenerative, inflammatory or post-traumatic arthritis of the distal radioulnar joint. The authors present three clinical cases of distal radioulnar pathological conditions: two patients with post-traumatic sequelae and one case of distal radioulnar impingement after a Sauvé-Kapandji operation. The three cases were treated surgically with a metallic prosthesis to replace the distal ulna (First Choice - Ascension®). The first two were treated with a resurfacing prosthesis and the last one with a modular prosthesis. All of the patients had achieved pain relief and increased movement of the distal radioulnar joint after one year of postoperative follow-up.

Distal Ulna Leiomyosarcoma Treated with Custom Polymethylmethacrylate Prosthesis with a 4-Year Follow-up

“…However, most of them are designed to be used in patients with intact soft tissue and stabilizing ligaments at the DRUJ. These devices, therefore, are not appropriate for use in patients who have undergone resection of the DRUJ because anteroposterior stability is not fully restored and suturing soft tissue limits mobility [20, 28, 29, 31]; reinsertion of the soft tissues at the metallic head may be difficult in patients who have undergone several surgical interventions, and to improve the adaptation of the implant, it may be necessary to remodel and deepen the sigmoid notch of the radius [27].…”

Clinical, radiological and patient-rated outcome comparison between total and partial ulnar head implants

“…This eccentricity of rotational axis compared with the ulnar shaft axis adjusts the ligament and interosseous membrane tension (Gordon et al, 2002;Kopylov and Ta ¨gil, 2007). However, only little information is available about the partial UHI and long-term results are missing (Adams and Gaffey, 2017;Conaway et al, 2009;Kopylov and Ta ¨gil, 2007;Santos et al, 2011).…”