title: [Dorsal capsular imbrication for dorsal instability of the distal radioulnar joint].
abstract: OBJECTIVE
  To stabilize the distal radioulnar joint (DRUJ) by performing dorsal capsular imbrication in patients presenting with dorsal instability. The goal was to reduce pain and prevent the occurrence of posttraumatic arthrosis.
  
  
  METHODS
  Posttraumatic dorsal instability of the DRUJ with missing block while performing translational activities in the DRUJ or subluxation while actively rotating the forearm. Cases, in which other stabilizing techniques, such as, sutures of the triangular fibrocartilage complex failed.
  
  
  METHODS
  DRUJ arthrosis, previous surgical interventions to the capsule area of the DRUJ, instabilities due to osseous reasons (malposition or pseudarthrosis) should already have been treated.
  
  
  METHODS
  Dorsal approach and opening of the 5th extensor compartment to expose the dorsal joint capsule. A longitudinal division of the capsule was performed and sufficient tissue on the radial and ulnar border was retained to ensure a solid suture technique. Then 2 U-shaped sutures using FiberWire suture material were made. Correction of the malposition and repositioning the forearm into supination. Tightening of the prepared capsule sutures and closing of the retinaculum with a resorbable suture.
  
  
  METHODS
  Patients wore a long-arm cast with the forearm being in supination for a period of 4 weeks. Following cast removal, patients wore a forearm splint for a period of 4 weeks to limit forearm pronation/supination at 45°. Full load on the wrist was allowed after 12 weeks.
  
  
  RESULTS
  The subjective and functional outcomes of 20 patients having received capsular imbrication using this technique were good and entailed no significant complications. The postoperative DASH was 15.8 points. Of the 20 patients, 17 patients (85%) had a reduction of pain. Symptoms of DRUJ instability could be reduced in 18 patients (90%). Pronation/supination of the wrist was not restricted postoperatively.
authors.affiliation: Handchirurgie Vulpiusklinik, Vulpiusstr. 29, 74906, Bad Rappenau, Deutschland, unglaub@vulpiusklinik.de.
authors.forename: F
authors.initials: F
authors.lastname: Unglaub
authors.forename: S
authors.initials: S
authors.lastname: Manz
authors.forename: T
authors.initials: T
authors.lastname: Bruckner
authors.forename: F M
authors.initials: FM
authors.lastname: Leclère
authors.forename: P
authors.initials: P
authors.lastname: Hahn
authors.forename: M B
authors.initials: MB
authors.lastname: Wolf
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000000981:diagnostic imaging / Q000601:surgery*; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011884:Radius / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D013536:Suture Techniques / Q000295:instrumentation* / Q000534:rehabilitation*; D013580:Synostosis / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014457:Ulna / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult