title: [Articular external fixation for chronic dorsal instability of distal radioulnar joint].
abstract: OBJECTIVE
  To discuss the clinical result of extrinsic radioulnar tether combined with anchoring nail fixation for treating chronic dorsal instability of the distal radioulnar joint (DRUJ).
  
  
  METHODS
  Between July 2011 and December 2012, 6 patients with chronic dorsal instability of the DRUJ were treated with extrinsic radioulnar tether combined with anchoring nail fixation. There were 1 male and 5 females with the average age of 27.3 years (range, 22-35 years). All of 6 patients had a wrist trauma history. The average disease duration was 4.8 years (range, 6 months to 15 years). Radiographs were taken postoperatively to observe the anchoring nail loosening. The stress test and forearm rotation test were used to evaluate the function of DRUJ. The complications, the grip power, range of motion, and visual analogue scale (VAS) scores were recorded at last follow-up. And the joint function was evaluated by disability of arm, shoulder, and hand (DASH) score.
  
  
  RESULTS
  Primary healing of incision was obtained in all cases, without any complications such as infection and ulnar neck fracture. All 6 patients were followed up 6-24 months (mean, 13.7 months). Stability was achieved in all patients. Radiographs showed that the joint space was widened and dislocation of the ulnar head was improved at 3 and 6 months after operation. The results of the stress test and forearm rotation test were negative. At last follow-up, the grip power, DASH score, VAS score, and range of motion of the wrist were significantly improved when compared with preoperative ones (P < 0.05).
  
  
  CONCLUSIONS
  Extrinsic radioulnar tether combined with anchoring nail fixation is an easy method of surgical revision to treat chronic dorsal instability of DRUJ, which can maintain the stability and protect the blood supply of triangular fibrocartilage complex.
authors.forename: Zongyuan
authors.initials: Z
authors.lastname: Jiang
authors.forename: Jiang
authors.initials: J
authors.lastname: Xia
authors.forename: Tao
authors.initials: T
authors.lastname: Ma
authors.forename: Lei
authors.initials: L
authors.lastname: Xu
authors.forename: Caizhi
authors.initials: C
authors.lastname: Hu
authors.forename: Yinze
authors.initials: Y
authors.lastname: Wang
authors.forename: Bin
authors.initials: B
authors.lastname: Hu
mesh_terms: D000328:Adult; D002908:Chronic Disease; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries / Q000601:surgery; D008297:Male; D010147:Pain Measurement; D016059:Range of Motion, Articular; D053441:Suture Anchors; D013710:Tendons / Q000601:surgery*; D053656:Tenodesis / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult