title: Midterm functional outcome after dorsal capsular imbrication for posttraumatic instability of the distal radioulnar joint.
abstract: BACKGROUND
  The dorsal capsular imbrication of the distal radioulnar joint (DRUJ) which was performed because of posttraumatic dorsal instability showed promising functional results after the first postoperative years. Therefore, we hypothesized that patients after capsular imbrication are characterized by good subjective and functional outcome measurements after a midterm period.
  
  
  METHODS
  Eleven patients (range 21-50 years of age; median 35 years of age) were examined after capsular imbrication of the DRUJ because of posttraumatic instability with a mean follow-up time of 72 months (range 46-114 months; median 66 months). Examination parameters included the determination of range of motion (ROM), grip strength, pain and functional outcome scores (modified Mayo wrist score (MMWS); Disabilities of the Arm, Shoulder and Hand questionnaire (DASH score)).
  
  
  RESULTS
  A mean DASH score of 6.7 (range 0-22.5) and mean MMWS of 91.8 (range 75-100) were measured. Grip strength reached 96.7 % of the contralateral hand. Range of motion reached at least 93.1 % of the contralateral hand. Eight of 11 patients regarded functional outcome and pain reduction as excellent. Six of 11 patients did not recognize a diagnosed instability of DRUJ as such. Ulnar-sided wrist pain was the apparent symptom in these cases.
  
  
  CONCLUSIONS
  Capsular imbrication of the DRUJ is a reliable and sufficient treatment option in case of posttraumatic dorsal instability. Since DRUJ instability is seldom recognized by the patients as such, a standardised diagnostic algorithm is mandatory to guarantee reliability and efficacy for identifying DRUJ instability.
authors.affiliation: Abteilung für Handchirurgie, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Ahrens
authors.forename: Frank
authors.initials: F
authors.lastname: Unglaub
authors.forename: Thomas
authors.initials: T
authors.lastname: Bruckner
authors.forename: Peter
authors.initials: P
authors.lastname: Hahn
authors.forename: Lars P
authors.initials: LP
authors.lastname: Müller
authors.forename: Kilian
authors.initials: K
authors.lastname: Wegmann
authors.forename: Christian Karl Georg
authors.initials: CK
authors.lastname: Spies
mesh_terms: D000328:Adult; D018771:Arthralgia; D004185:Disability Evaluation; D005260:Female; D018737:Hand Strength; D006801:Humans; D017746:Joint Capsule / Q000601:surgery*; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D010147:Pain Measurement; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D020127:Recovery of Function; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000601:surgery*; D014955:Wrist Joint / Q000601:surgery*