Distal radioulnar joint volar instability after ligament reconstruction failure treated with sigmoid notch osteotomy.
Because osseous abnormalities result in distal radioulnar joint instability, a sigmoid notch osteotomy is used to restore stability. This article describes a case of distal radioulnar joint volar instability treated with sigmoid notch osteotomy of the volar rim.A 22-year-old man presented with a 9-month history of right wrist pain with volar instability after a fall, which was treated conservatively. He reported a history of remote trauma when he was 7 years old but had been asymptomatic since then. Four months later, he underwent anatomical distal radioulnar joint ligament reconstruction at another hospital after a diagnosis of distal radioulnar joint instability, but the instability had persisted.Computed tomography revealed dynamic volar subluxation of the ulnar head with hypoplasia and a flattened volar lip of the sigmoid notch. Therefore, a sigmoid notch osteotomy of the volar rim was performed. Postoperatively, an above-elbow cast was applied with forearm pronation for 6 weeks. Six months later, the patient had regained 60° of supination and 70° of pronation. He reported minor pain and no instability. Computed tomography scan at 6 months postoperatively revealed union of the osteotomy site and confirmed the maintenance of reduction. The patient returned to work.
Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Wonmi-Gu, Bucheon-Si, Gyeonggi-Do, Republic of Korea.
Byung-Sung
BS
Kim
Hyun-Seok
HS
Song
Koo-Hwang
KH
Jung
Hyung-Tae
HT
Kim
D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008022:Ligaments / Q000601:surgery*; D008297:Male; D011884:Radius / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome; D014457:Ulna / Q000601:surgery*; D014955:Wrist Joint / Q000601:surgery*; D055815:Young Adult