Long-term functional outcome after dorsal capsular imbrication for post-traumatic dorsal instability of the distal radioulnar joint

Unglaub, Julia M.; Heyse, Thomas J.; Brückner, Thomas; Langer, Martin; Spies, Christian

doi:10.1007/s00264-020-04705-8

Cited by 4 publications

(5 citation statements)

References 28 publications

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“…Using DCI as a sole treatment for patients with DRUJ instability has been successful in restoring DRUJ stability in 97.8% of cases, with 93.6% of patients experiencing pain relief through this approach [17][18][19][20][21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

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Effect of Dorsal Capsular Imbrication on Intraoperative DRUJ Instability following Arthroscopic TFCC Repair Surgery

Yeh,

Hsu,

Lee

et al. 2024

Preprint

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Background Distal radioulnar joint (DRUJ) stability during unrestricted forearm rotation relies on several factors, including the integrity of the triangular fibrocartilage complex (TFCC), the interosseous membrane, the bony configuration of the sigmoid notch, DRUJ capsule, and the extensor carpi ulnaris tendon with its subsheath. There are currently numerous reported surgical approaches for TFCC repair, however, postoperative DRUJ instability rates are still reported to be around 8 to 12%. As the integrity and strength of the TFCC is crucial for DRUJ stability, it is thus critical to identify if intraoperative dorsal capsular imbrication can further enhance DRUJ stability for improved functional outcomes. Methods A retrospective study was performed on patients who underwent arthroscopic TFCC repair between 2016 and 2021. Inclusion criteria comprised a symptomatic ulna fovea sign for over 6 months and dorsal DRUJ subluxation on magnetic resonance imaging. A total of 225 patients were assessed to be suitable and recruited for our study. 135 patients underwent our arthroscopic “cross-form TFCC repair” without dorsal capsular imbrication (CR) and 90 patients underwent our arthroscopic “cross-form TFCC repair” with dorsal capsular imbrication for augmentation of DRUJ stability (DCI). Pain visual analog scale score (VAS), grip strength, modified Mayo Wrist Score (MMWS), wrist range of motion (ROM), and patient-reported outcomes (PRO) were evaluated, and all patients were follow-up for a minimum of 3 years postoperatively. Results Both groups showed significant improvements in pain VAS score, grip strength, wrist ROM, MMWS, and PRO between the preoperative and postoperative periods (p < 0.05). Significantly lower recurrent DRUJ instability was noted in the DCI group (3.7% vs 1.1%, p < 0.05). Re-operative rates were also noted to be lower in the DCI group (2.2% vs 1.1%). However, the DCI group was found to have inferior ROM as compared to the CR group. Conclusion Dorsal DRUJ capsular imbrication effectively reduces postoperative DRUJ instability and reoperation rates, enhances grip strength, and maintains wrist ROM in patients with a positive intra-operative ballottement test after arthroscopic TFCC repair.

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Section: Discussionmentioning

confidence: 99%

“…The dorsal capsular imbrication (DCI) technique has been proposed and reported to yield positive clinical results in chronic DRUJ dislocation cases [17][18][19][20][21][22][23][24][25]. However, the use of DCI as a reinforcement procedure in TFCC repair operations for chronic DRUJ instability has not been extensively studied.…”

Section: Introductionmentioning

confidence: 99%

Effect of Dorsal Capsular Imbrication on Intraoperative DRUJ Instability following Arthroscopic TFCC Repair Surgery

Yeh,

Hsu,

Lee

et al. 2024

Preprint

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“…Gofton et al 28 compared the dorsal capsular imbrication and 3 other types of surgical reconstruction for the treatment of DRUJ instability, concluding that the Adams reconstruction, 23 the modified Fulkerson-Watson reconstruction, 29 and the Bowers reconstructions 30 significantly improved the stability, but stated that the capsular imbrication was the repair technique that most resembles the DRUJ kinematics. Manz et al, 16 Kouwenhoven et al, 17 Ahrens et al, 18 Unglaub et al 19 and Spies et al, 20 published their case series of DRUJ posttraumatic instability that was treated by a dorsal joint capsule imbrication with excellent results. This technique has become our main surgical option for the treatment of DRUJ chronic posttraumatic instability, because it is relatively simple, easily reproducible, without the need for grafting and large bone perforations, as well as multiple incisions.…”

Section: Discussionmentioning

confidence: 99%

“…11 Some articles state that in addition to the TFCC, the joint capsule also has a critical stabilizing function; 12-15 and therefore, many authors are considering the capsular imbrication as a surgical option in cases of the DRUJ posttraumatic instability. 16-20…”

Section: Introductionmentioning

confidence: 99%

“…11 Some articles state that in addition to the TFCC, the joint capsule also has a critical stabilizing function; [12][13][14][15] and therefore, many authors are considering the capsular imbrication as a surgical option in cases of the DRUJ posttraumatic instability. [16][17][18][19][20] The extensor retinaculum imbrication can also be used to restore the DRUJ stability. This technique consists of making an ulnar-based retinacular flap that crosses the fifth extensor compartment to create extra-articular support similar to the anatomical course of the dorsal radioulnar ligament.…”

Section: Introductionmentioning

confidence: 99%

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Chronic Posttraumatic Instability of the Distal Radioulnar Joint: Foveal Reattachment of the Triangular Fibrocartilage Complex With Dorsal Capsuloplasty and Extensor Retinaculum Imbrications

Neto

2020

Hand (New York, N,Y.)

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Background: The purpose of this article is to describe the surgical technique used by the authors and the outcome in the treatment of chronic posttraumatic instability of the distal radioulnar joint (DRUJ). Methods: A retrospective study was conducted analyzing the medical records of 11 patients with chronic posttraumatic instability of the DRUJ, treated by a foveal reattachment of the triangular fibrocartilage complex with dorsal capsular and extensor retinaculum imbrications between 2016 and 2017, with a follow-up evaluation of 1 year. Results: All patients reported pain relief and the absence of instability, returning to normal activities in 3 to 6 months. Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire ranged from 2 to 25, resulting in a mean score of 9.5. Forearm rotation averaged 89° of pronation and 85° of supination. Conclusion: Foveal reattachment of the triangular fibrocartilage complex with dorsal capsular and extensor retinaculum imbrications is an effective surgical procedure for the treatment of DRUJ chronic posttraumatic instability.

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Midterm Results of Arthroscopy-Assisted “Tent Form” Triangular Fibrocartilage Complex Repair With Dorsal Distal Radioulnar Joint Capsule Imbrication for Posttraumatic Chronic Distal Radioulnar Joint Instability

Hsu

Wei

et al. 2022

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Long-term functional outcome after dorsal capsular imbrication for post-traumatic dorsal instability of the distal radioulnar joint

Cited by 4 publications

References 28 publications

Effect of Dorsal Capsular Imbrication on Intraoperative DRUJ Instability following Arthroscopic TFCC Repair Surgery

Effect of Dorsal Capsular Imbrication on Intraoperative DRUJ Instability following Arthroscopic TFCC Repair Surgery

Chronic Posttraumatic Instability of the Distal Radioulnar Joint: Foveal Reattachment of the Triangular Fibrocartilage Complex With Dorsal Capsuloplasty and Extensor Retinaculum Imbrications

Midterm Results of Arthroscopy-Assisted “Tent Form” Triangular Fibrocartilage Complex Repair With Dorsal Distal Radioulnar Joint Capsule Imbrication for Posttraumatic Chronic Distal Radioulnar Joint Instability

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