title: Ulnar Head Replacement: 21 Cases; Mean Follow-Up, 7.5 Years.
abstract: OBJECTIVE
  To report clinical and radiographic outcomes for the Herbert ulnar head prosthesis after a mean of 7.5 years (range, 2.0-12.5 years).
  
  
  METHODS
  We performed 22 Herbert ulnar head prosthesis arthroplasties between 2000 and 2011. Five were primary procedures, and the remaining 17 were done after an average of 2 (range, 1-5) previous operations. The mean age at surgery was 55 years (range, 31-74 years). Follow-up including clinical examination, standardized questionnaires, and radiographic examination was done after mean 7.5 years (range, 2.0-12.5 years) in 21 cases. We used the Disabilities of the Arm, Shoulder, and Hand questionnaire, the Patient-Rated Wrist Evaluation questionnaire, and the Mayo wrist score questionnaire. Pain and satisfaction were evaluated with a 10-cm visual analog scale (VAS). Measurements of range of motion and strength for grip were recorded.
  
  
  RESULTS
  Wrist range of motion was not affected by the arthroplasty except for supination, which significantly improved from 55° to 70°. At follow-up, grip strength averaged 25 kg (range, 10-48 kg) in the operated wrists and 31 kg (range, 8-74 kg) on the contralateral side. Visual analog scale-pain averaged 2.9 (range, 0-8.7) during activity and 1.7 (range, 0-7) at rest. Satisfaction VAS was 8.9 (range, 4.3-10). Five patients had VAS-pain above 5 during activity, and 1 patient was dissatisfied and regretted having undergone arthroplasty. Mean outcomes were 27 (range, 5-50) for Disabilities of the Arm, Shoulder, and Hand measure, 31 (range, 0-90) for the Patient-Rated Wrist Evaluation score, and 71 (range, 30-90) for the Mayo wrist score. One patient was reoperated with capsuloplasty 9 months after the arthroplasty owing to recurrence of painful instability. Full stability was not achieved but the pain resolved. None of the implants showed any radiographic signs of loosening.
  
  
  CONCLUSIONS
  The Herbert ulnar head prosthesis was a safe method of treatment and provided satisfactory midterm results for selected cases of distal radioulnar joint disorders.
  
  
  CONCLUSIONS
  Increased knowledge of performance for ulnar head implant arthroplasty may aid surgical decision making for distal radioulnar joint disorders.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Hand Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: peter.axelsson@vgregion.se.
authors.forename: Peter
authors.initials: P
authors.lastname: Axelsson
authors.affiliation: Department of Hand Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Christer
authors.initials: C
authors.lastname: Sollerman
authors.affiliation: Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Kärrholm
mesh_terms: D000328:Adult; D000368:Aged; D019643:Arthroplasty, Replacement / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011474:Prosthesis Design; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014457:Ulna / Q000601:surgery*; D014955:Wrist Joint / Q000601:surgery*
keywords: Distal radioulnar joint; ulnar head prosthesis; ulnar head replacement; wrist arthroplasty