title: Functional Outcomes of the Aptis-Scheker Distal Radioulnar Joint Replacement in Patients Under 40 Years Old.
abstract: OBJECTIVE
  To study the functional results after Aptis-Scheker distal radioulnar joint (DRUJ) replacement in young patients.
  
  
  METHODS
  We performed a retrospective study selecting all patients under age 40 years, with a clinical and radiological follow-up longer than 2 years, who underwent DRUJ replacement. Patients' charts were reviewed and age at surgery, profession, hobbies, comorbidities, diagnosis, previous procedures, and complications were recorded. Preoperative and postoperative Disabilities of Arm, Shoulder, and Hand and Patient-Rated Wrist Evaluation scores, visual analog scale score, grip strength, lifting capacity, and wrist range of motion were recorded. Functional results and characteristics of the patients were correlated with linear regression. A Kaplan-Meier curve was plotted.
  
  
  RESULTS
  We performed 46 arthroplasties. Average patient age was 32 years. Forty-one arthroplasties were performed for pain and 5 for pain and instability. Average follow-up was 61 months. Thirty-seven patients underwent multiple procedures before DRUJ replacement (1.7 ± 1.2 procedures). Extensor carpi ulnaris release with implant coverage using a local adipofascial flap (5) or dermal-fat graft (4) was the most common procedure performed after implantation of the prosthesis. Thirty surgeries were undertaken to address complications after DRUJ replacement in 15 wrists. A total of 36 procedures not related to DRUJ replacement were performed in 15 wrists after the arthroplasty. Grip, lifting, Disabilities of Arm, Shoulder, and Hand and Patient-Rated Wrist Evaluation scores, visual analog scale score, and supination showed statistically significant improvement after surgery. Functional results were comparable in patients who received the implant with either a standard or extended stem. Patient age and number of the previous procedures did not correlate with functional results. The 5-year survival of the implant was 96%.
  
  
  CONCLUSIONS
  In this group of young patients, the implant improved the functional status of the extremity. The most frequent complication was extensor carpi ulnaris tendonitis, which was addressed by interposition of an adipofascial flap.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Plastic Surgery Department, Cleveland Clinic, Cleveland, OH.
authors.forename: Antonio
authors.initials: A
authors.lastname: Rampazzo
authors.affiliation: Plastic Surgery Department, Cleveland Clinic, Cleveland, OH.
authors.forename: Bahar Bassiri
authors.initials: BB
authors.lastname: Gharb
authors.affiliation: Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY.
authors.forename: Guy
authors.initials: G
authors.lastname: Brock
authors.affiliation: Kleinert Institute, Louisville, KY. Electronic address: lscheker@kleinertkutz.com.
authors.forename: Luis R
authors.initials: LR
authors.lastname: Scheker
mesh_terms: D000293:Adolescent; D000328:Adult; D019643:Arthroplasty, Replacement / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D007595:Joint Prosthesis; D008297:Male; D010147:Pain Measurement; D020127:Recovery of Function; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014955:Wrist Joint / Q000601:surgery*
keywords: Arthritis; distal radioulnar joint; implant; prosthesis; replacement