Comparison of distal radioulnar joint reconstructions using an active joint motion simulator.
OBJECTIVE
Distal radioulnar joint (DRUJ) instability can result in pain and functional disability. Numerous DRUJ reconstructive options have been described with minimal biomechanical analysis. The purpose of this study was to evaluate the ability of 4 well-described DRUJ reconstructions to restore joint kinematics using a dynamic, motion-controlled simulator.


METHODS
Eleven cadaveric upper extremities had computer-controlled simulated active forearm rotation. Joint kinematics were quantified by using an electromagnetic tracking system. We compared the passive and simulated active kinematics of the intact, unstable, and reconstructed DRUJ (capsular repair, 2 described radioulnar ligament reconstructions, and a radioulnar tethering procedure).


RESULTS
All reconstructions improved significantly the kinematics of the unstable DRUJ. The capsule repair restored simulated active joint kinematics closest to the intact DRUJ.


CONCLUSIONS
All 4 reconstructions improved DRUJ stability significantly. The capsule repair most closely matched intact DRUJ kinematics and the radioulnar ligament reconstructions were found to be superior to a radioulnar tethering procedure.
Gofton
Wade T
WT
Bioengineering Laboratory, Hand and Upper Limb Centre, St. Joseph's Health Centre, Department of Surgery and Biomedical Engineering, University of Western Ontario, London, Ontario, Canada.
Gordon
Karen D
KD
Dunning
Cynthia E
CE
Johnson
James A
JA
King
Graham J W
GJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011403:Pronation / Q000502:physiology; D011884:Radius / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012399:Rotation; D013484:Supination / Q000502:physiology; D014457:Ulna / Q000601:surgery*; D014955:Wrist Joint / Q000503:physiopathology / Q000601:surgery*