title: Capsular imbrication for posttraumatic instability of the distal radioulnar joint.
abstract: OBJECTIVE
  To analyze functional and subjective outcomes of patients with posttraumatic dorsal instability of the distal radioulnar joint (DRUJ) treated by a dorsal capsular imbrication.
  
  
  METHODS
  We reviewed 11 patients (7 men and 4 women) with posttraumatic instability of the DRUJ who were treated by a capsular imbrication. The patients ranged in age from 18 to 48 years (average, 33 y). The duration of symptoms before surgery ranged from 3 weeks to 6 months (average, 5 mo). We evaluated subjective outcome measurements such as the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, questions regarding symptoms of pain and instability, and overall satisfaction. Objective outcome measurements were physical examination, standard radiographs, and a review of any surgical complications. Patients were asked whether they experienced wrist tenderness with applied pressure, swelling, scar sensitivity, or pain. We determined functional outcome using the Modified Mayo Wrist Score including range of motion and grip strength. The score was used to evaluate the surgical technique and enable comparison with other surgical methods used to treat instability of the DRUJ.
  
  
  RESULTS
  After surgery, the total mean DASH score was 15 points. Range of motion, grip strength, pain, and overall function resulted in a mean Modified Mayo Wrist Score of 88 points, and therefore a good functional outcome. Three patients were noted to have persistent mild DRUJ instability on the stress test but did not have symptoms. The only intraoperative or postoperative complications observed were transient paresthesias on the ulnar side of the hand.
  
  
  CONCLUSIONS
  Capsular imbrication for posttraumatic instability of the DRUJ is a highly effective procedure with few complications and good functional and subjective results even in cases with concomitant healed fractures of the radius or ulnar styloid.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Hand Surgery, Vulpius Klinik, Bad Rappenau, Vulpiusstrasse 29, 74906 Bad Rappenau, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Manz
authors.forename: Maya B
authors.initials: MB
authors.lastname: Wolf
authors.forename: Franck Marie
authors.initials: FM
authors.lastname: Leclère
authors.forename: Peter
authors.initials: P
authors.lastname: Hahn
authors.forename: Thomas
authors.initials: T
authors.lastname: Bruckner
authors.forename: Frank
authors.initials: F
authors.lastname: Unglaub
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017746:Joint Capsule / Q000601:surgery*; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D011182:Postoperative Care / Q000379:methods; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000601:surgery; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D014457:Ulna / Q000000981:diagnostic imaging / Q000601:surgery; D014954:Wrist Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014955:Wrist Joint / Q000601:surgery*; D055815:Young Adult