Orthopedic Surgery, Dept., Faculty of Medicine, Benha Univ., Benha, Egypt
Abstract
Background: Distal radioulnar joint injuries are relatively uncommon but sometimes overlooked, and they're often coupled with fractures of both the distal radius and the ulnar styloid. Galeazzi and Essex-Lopresti fractures are the most prevalent causes of distal radioulnar joint injuries. The triangular fibrocartilage or the radioulnar ligaments might be directly involved in the damage. Assessment of long-term stability of the distal oblique bundle (DRUJ) via reconstruction is the goal of this study. a patient's condition and the approach used; It was our goal to see how the treatment of chronic DRUJ instability by interosseous membrane repair will affect the result between January 2020 and June 2021. Using the DOB repair procedure, eleven patients with persistent DRUJ instability were successfully cured. The following criteria were used to select all of the patients: between the ages of 15 and 50 Without arthritis, the DRUJ is unstable. The following criteria were used to exclude patients: Rheumatoid arthritis, DRUJ, or wrist arthritis are all examples of systemic illnesses. At a mean of 3 and 6 months, all patients were accessible for follow-up. The following is a description of the method: The palmaris longus tendon is harvested using a percutaneous approach and a tunnel is carved through the ulna and radius in an oblique orientation, immediately proximal to the sigmoid notch. This procedure allows the distal oblique bundle to be successfully reattached by over-boring the radial cortex, resulting in an extremely strong connection between both bones (DOB). With the ulna in full supination, an interference screw is used to keep the ulna from slipping out of the sigmoid notch. Results; All patients had a stable DRUJ after surgery. All of the patients improved clinically, functionally, and radiographically throughout the course of their treatment. If non-surgical treatment fails or the patient has clinical signs of instability, laxity in the DRUJ or no malunion or arthritis, the distal bundle reconstruction may be employed. This simple percutaneous procedure seems to be a potential approach of treating chronic instability in this critical joint if the patients are properly chosen. Allows for the preservation of surrounding soft tissue, particularly those tissues that provide residual joint stability. It is a useful alternative to more intrusive treatments.
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