title: Ligament reconstruction using the Fulkerson-Watson method to treat chronic isolated distal radioulnar joint instability: short-term results.
abstract: OBJECTIVE
  Isolated distal radioulnar instability may remain unrecognized during the acute period of trauma as it is difficult to diagnose, and does not become obvious until later when it has become chronic. We present early results in patients who underwent stabilization with extraarticular ligament reconstruction (Fulkerson-Watson reconstruction).
  
  
  METHODS
  Four women and 1 man underwent surgery for chronic isolated distal radioulnar joint instability demonstrated in X-rays and magnetic resonance images. Arthroscopy revealed avulsion of the triangular fibrocartilage complex from the point of insertion in 3 patients, and peripheral tears in 2 patients. The peripheral tears were debrided arthroscopically. All patients had an adequate sigmoid notch and therefore underwent ligament reconstruction using the Fulkerson-Watson method. Postoperative evaluations were done with MRI.
  
  
  RESULTS
  Mean follow-up was 15.5 months (range 6-26 months). Stability was achieved in all patients. The mean Quick-DASH symptom score decreased from 18.63 (15.90-22.72) to 6.81 (2.27-9.09) after surgery. A mean visual analogue score to assess pain decreased from 7.32 (6.30-8.40) to 1.88 (1.50-2.30) after surgery. Preoperative and postoperative measurements were 26° (passive 44°) and 47° (passive 65°) for active supination, 18° (passive 45°) and 49°(passive 68°) for active pronation, 20° (passive 43°) and 42° (passive 60°) for active wrist flexion,and 38° (passive 52°) and 45° (passive 59°) for active wrist extension.
  
  
  CONCLUSIONS
  Surgical revision of distal radioulnar joint instability using Fulkerson-Watson reconstruction is easier than intraarticular techniques and satisfactorily re-establishes stability, provided that the sigmoid notch is adequate.
authors.affiliation: İst-El, Hand Surgery Microsurgery and Rehabilitation Group, İstanbul, Turkey.
authors.forename: Hüsrev
authors.initials: H
authors.lastname: Pürisa
authors.forename: İlker
authors.initials: İ
authors.lastname: Sezer
authors.forename: Fatih
authors.initials: F
authors.lastname: Kabakaş
authors.forename: Serdar
authors.initials: S
authors.lastname: Tunçer
authors.forename: Erden
authors.initials: E
authors.lastname: Ertürer
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yazar
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D008023:Ligaments, Articular / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011182:Postoperative Care; D011403:Pronation; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D013484:Supination; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D051478:Triangular Fibrocartilage / Q000503:physiopathology / Q000601:surgery*; D014953:Wrist / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery