title: [Instability of the distal radioulnar joint: Treatment options for ulnar lesions of the triangular fibrocartilage complex].
abstract: Injuries of the triangular fibrocartilage complex (TFCC) may be fatal to the distal radioulnar joint (DRUJ). This structure is one of the crucial stabilizers and guarantees unrestricted pronosupination of the forearm. A systematic examination is mandatory to diagnose DRUJ instability reliably. A clinical examination in comparison to the contralateral side is obligatory. Plain radiographs are required to exclude osseous lesions or deformities. Computed tomography of both wrists in neutral, pronation and supination is necessary to verify DRUJ instability in ambiguous situations. Based on a systematic examination wrist and DRUJ arthroscopy identify lesions clearly. Injuries of the radioulnar ligaments which entail DRUJ instability, should be reconstructed preferably anatomically. Ulnar-sided TFCC lesions may often cause DRUJ instability. Osseous ligament avulsions are mostly treated osteosynthetically. Ligament tears may be refixated using anchor or transosseous sutures. Tendon transplants are necessary for an anatomical reconstruction in cases of irreparable ruptures.
authors.affiliation: Abteilung für Handchirurgie, Vulpius Klinik, Vulpiusstr. 29, 74906, Bad Rappenau, Deutschland, christian.spies@vulpiusklinik.de.
authors.forename: C K
authors.initials: CK
authors.lastname: Spies
authors.forename: K J
authors.initials: KJ
authors.lastname: Prommersberger
authors.forename: M
authors.initials: M
authors.lastname: Langer
authors.forename: L P
authors.initials: LP
authors.lastname: Müller
authors.forename: P
authors.initials: P
authors.lastname: Hahn
authors.forename: F
authors.initials: F
authors.lastname: Unglaub
mesh_terms: D001182:Arthroscopy / Q000379:methods*; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D011884:Radius / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D013536:Suture Techniques; D013580:Synostosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013709:Tendon Transfer / Q000379:methods; D051478:Triangular Fibrocartilage / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D014457:Ulna / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*