Salvage of failed distal radioulnar joint reconstruction.
In the patient in whom primary distal radioulnar joint surgery has failed, consideration must be given to the anatomy and biomechanics of the native joint; how this has been disrupted by injury, disease, and previous trauma; and what is required to reconstruct the joint. The forearm relies on a congruent condylar cam of the distal ulna, with intact soft tissue restraints for normal biomechanics. Surgical reconstruction using tendon graft, autologous bone graft, allograft interposition, and prosthetic reconstruction are discussed in this article. If these procedures fail, then salvage procedures including wide excision of the ulna or one-bone forearm can be performed.
Watts
Adam C
AC
Upper Limb Unit, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, WN6 9EP, UK. adamcwatts@hotmail.com
Hayton
Michael J
MJ
Stanley
John K
JK
D000465:Algorithms; D001168:Arthritis / Q000503:physiopathology / Q000601:surgery*; D001696:Biomechanical Phenomena; D016025:Bone Transplantation; D006801:Humans; D019637:Orthopedic Procedures; D019736:Prostheses and Implants; D016879:Salvage Therapy; D013710:Tendons / Q000503:physiopathology / Q000601:surgery; D014182:Transplantation, Autologous; D017211:Treatment Failure; D014457:Ulna / Q000601:surgery; D014955:Wrist Joint / Q000033:anatomy & histology / Q000503:physiopathology / Q000601:surgery*