Vol. 4 (01) pp. 2000-2007

RECONSTRUCTION OF THE RADIO-ULNAR LIGAMENTS USING FREE PALMARIS TENDON AUTOGRAFT GRAFT.

  • Orthopedic Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Sharkia Government, Egypt.
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Abstract

Introduction: The radio-ulnar ligaments of the triangular fibrocartilagenous complex are the primary intrinsic stabilizers of the DRUJ. In this study, isolated DRUJ instability was managed by reconstruction of the Radio-ulnar ligaments using free palmaris longus tendon autograft. Patient and Methods: Reconstruction of the Radioulnar ligaments was performed in fourteen patients complaining of post-traumatic radio-ulnar instability using free palmaris longus tendon autograft passing through drill holes in the distal radius and ulna. Results: Mayo wrist score improved from average 38.2points (poor) to be 90 points (excellent) with 9 patients excellent and 5 patients good. The average PRWE changed from 71.28 points to be 14.6 points. The average DASH score changed from 57.8 points to be 8.13 points. Changes in Mayo score, PRWE score and DASH score were significant at p < 0.05. Conclusion: Reconstruction of the radio-ulnar ligaments using free palmaris longus tendon autograft for management of isolated distal radio-ulnar instability can restore DRUJ stability, improve complex wrist motion and grip strength.

How to Cite This Article

Mohamed A. Abdel-Salam, Ahmed Mohamed Nahla and Ahmed Elsayed ElMalt. (2016); RECONSTRUCTION OF THE RADIO-ULNAR LIGAMENTS USING FREE PALMARIS TENDON AUTOGRAFT GRAFT., International Journal of Advanced Research (IJAR), 4 (01), 2000-2007, ISSN 2320-5407.

Corresponding Author

DR.Mohamed AbdAlla

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References

  1. AF Ekenstam F, Hagert CG. Anatomical studies on the geometry and stability of the distal radio ulnar joint. Scand J Plast Reconstr Surg. 1985; 19(1):17-25. Kihara H, Short WH, Werner FW, Fortino MD, Palmer AK. The stabilizing mechanism of the distal radioulnar joint during pronation and supination. J Hand Surg Am. 1995; 20(6):930-6.
  2. Ward LD, Ambrose CG, Masson MV, Levaro F. The role of the distal radioulnar ligaments, interosseous membrane, and joint capsule in distal radioulnar joint stability. J Hand Surg [Am] 2000; 25(2):341?51.
  3. Stuart PR, Berger RA, Linscheid RL, An KN. The dorsopalmar stability of the distal radioulnar joint. J Hand Surg [Am] 2000; 25 (4):689?99.
  4. Xu J, Tang JB. In vivo changes in lengths of the ligaments stabilizing the distal radioulnar joint. J Hand Surg. 2009; 34:40?5.
  5. Shaaban H, Giakas G, Bolton M, Williams R, Scheker LR, Lees VC. The distal radioulnar joint as a load-bearing mechanism?a biomechanical study. J Hand Surg Am. 2004; 29:85?95.
  6. Kleinman WB, Graham TJ: Distal ulnar injury and dysfunction. In Peimer CA, editor: Surgery of the hand and upper extremity, New York, 1996, McGraw-Hill, p 670.
  7. Seo KN, Park MJ, Kang HJ. Anatomic reconstruction of the distal radioulnar ligament for posttraumatic distal radioulnar joint instability. Clinics in orthopedic surgery. 2009 Sep 1; 1(3):138-45.
  8. Adams BD. Effects of radial deformity on distal radioulnar joint mechanics. J Hand Surg Am. 1993; 18:492?8.
  9. P?risa H, Sezer I, Kabakaş F, Tuncer S, Ert?rer E, Yazar M. Ligament reconstruction using the Fulkerson-Watson method to treat chronic isolated distal radioulnar joint instability: short-term results. Acta orthopaedica et traumatologica turcica. 2011;45(3):168-74.
  10. Dy CJ, Ouellette EA, Makowski AL. Extensor retinaculum capsulorrhaphy for ulnocarpal and distal radioulnar instability: the Herbert sling. Techniques in hand & upper extremity surgery. 2009 Mar 1; 13(1):19-22.
  11. Hui FC, Linscheid RL. Ulnotriquetral augmentation tenodesis: a reconstructive procedure for dorsal subluxation of the distal radioulnar joint. The Journal of hand surgery. 1982 May 1; 7(3):230-6.
  12. Gofton WT, Gordon KD, Dunning CE, et al. Comparison of distal radioulnar joint reconstructions using an active joint motion simulator. J Hand Surg. 2005; 30:733?42.
  13. Jang E, Dy CJ, Wolfe SW. Selection of Tendon Grafts for Distal Radioulnar Ligament Reconstruction and Report of a Modified Technique. Journal of Hand Surgery. 2014 Oct 1; 39(10):2027-32.
  14. Adams BD, Lawler E. Chronic instability of the distal radioulnar joint. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2007 Sep 1; 15(9):571-5.
  15. Henry M. Anatomic reconstruction of the radioulnar ligament. Hand. 2012 Dec; 7(4):413-9.