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Management of the Distal Radioulnar Joint in Rheumatoid Arthritis

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Clinical Management of the Rheumatoid Hand, Wrist, and Elbow

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Abstract

The distal radioulnar joint (DRUJ) is frequently problematic in rheumatoid arthritis, but the signs and symptoms are variable in timing and severity. Because of the risk of tendon ruptures associated with chronic synovitis, examinations should be repeated regularly. The three traditional surgical options for advanced arthritis are the Darrach resection, Sauvé–Kapandji procedure, and hemiresection of the distal ulna. Distal ulna stabilization using a local tenodesis or capsular flap and a soft tissue interposition are often used to reduce radioulnar impingement. If the rheumatoid disease is quiescent, the joint is not subluxated, and the bone quality is adequate, then implant arthroplasty can be considered.

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References

  1. O’Donovan TM, Ruby LK. The distal radioulnar joint in rheumatoid arthritis. Hand Clin. 1989;5:249–56.

    PubMed  Google Scholar 

  2. Backdahl M. The caput ulnae syndrome in rheumatoid arthritis: a study of the morphology, abnormal anatomy and clinical picture. Acta Rheumatol Scand Suppl. 1963;5:1–75.

    CAS  PubMed  Google Scholar 

  3. Spinner M, Kaplan EB. Extensor carpi ulnaris: its relationship to the stability of the distal radio-ulnar joint. Clin Orthop. 1970;68:124–9.

    Article  CAS  PubMed  Google Scholar 

  4. DiBenedetto MR, Lubbers LM, et al. Long-term results of the minimal resection Darrach procedure. J Hand Surg [AM]. 1991;16:445–50.

    Article  CAS  Google Scholar 

  5. Nolan 3rd WB, Eaton RG. A Darrach procedure for distal ulnar pathology derangements. Clin Orthop. 1992;275:85–9.

    PubMed  Google Scholar 

  6. Tulipan DJ, Eaton RG, et al. The Darrach procedure defended: technique redefined and long-term follow-up. J Hand Surg [Am]. 1991;16:438–44.

    Article  CAS  Google Scholar 

  7. Blatt G, Ashworth C. Volar capsule transfer for stabilization following resection of the distal end of the ulna. Orthop Trans. 1979;3:13–4.

    Google Scholar 

  8. Tsai TM, Shimizu H, et al. A modified extensor carpi ulnaris tenodesis with the Darrach procedure. J Hand Surg [Am]. 1993;18:697–702.

    Article  CAS  Google Scholar 

  9. Breen TF, Jupiter JB. Extensor carpi ulnaris and flexor carpi ulnaris tenodesis of the unstable distal ulna. J Hand Surg [Am]. 1989;14:612–7.

    Article  CAS  Google Scholar 

  10. Leslie BM, Carlson G, et al. Results of extensor carpi ulnaris tenodesis in the rheumatoid wrist undergoing a distal ulnar excision. J Hand Surg [Am]. 1990;15:547–51.

    Article  CAS  Google Scholar 

  11. Johnson RK. Stabilization of the distal ulna by transfer of the pronator quadratus origin. Clin Orthop. 1992;275:130–2.

    PubMed  Google Scholar 

  12. Bowers WH. Distal radioulnar joint arthroplasty: the hemiresection-interposition technique. J Hand Surg [Am]. 1985;10:169–78.

    Article  CAS  Google Scholar 

  13. Watson HK, Gabuzda GM. Matched distal ulna resection for posttraumatic disorders of the distal radioulnar joint. J Hand Surg [Am]. 1992;17:724–30.

    Article  CAS  Google Scholar 

  14. Kapandji IA. The Kapandji-Sauve procedure. J Hand Surg [Br]. 1992;17:125–6.

    Article  Google Scholar 

  15. Millroy P, Coleman S, et al. The Sauve-Kapandji operation: technique and results. J Hand Surg [Br]. 1992;17:411–4.

    Article  CAS  Google Scholar 

  16. Rothwell AG, O’Neill L, et al. Sauve-Kapandji procedure for disorders of the distal radioulnar joint: a simplified technique. J Hand Surg [Am]. 1996;21:771–7.

    Article  CAS  Google Scholar 

  17. Nakamura R, Tsunoda K, et al. The Sauve-Kapandji procedure for chronic dislocation of the distal radio-ulnar joint with destruction of the articular surface. J Hand Surg [Br]. 1992;17:127–32.

    Article  CAS  Google Scholar 

  18. Vincent KA, Szabo RM, et al. The Sauve-Kapandji procedure for reconstruction of the rheumatoid distal radioulnar joint. J Hand Surg [Am]. 1993;18:978–83.

    Article  CAS  Google Scholar 

  19. Fujita S, Masada K, et al. Modified Sauve-Kapandji procedure for disorders of the distal radioulnar joint in patients with rheumatoid arthritis. J Bone Joint Surg. 2005;87-A:134–9.

    Article  Google Scholar 

  20. Willis AA, Berger RA, Cooney III WP. Arthroplasty of the distal radioulnar joint using a new ulnar head endoprosthesis: preliminary report. J Hand Surg Am. 2007;32(2):177–89.

    Article  PubMed  Google Scholar 

  21. Yen Shipley N, Dion GR, Bowers WH. Ulnar head implant arthroplasty: an intermediate term review of 1 surgeon’s experience. Tech Hand Up Extrem Surg. 2009;13(3):160–4.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Baylor College of Medicine, 7200 Cambridge, Suite 10A, Houston, TX, 77030, USA

    Brian D. Adams MD

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  1. Brian D. Adams MD
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Correspondence to Brian D. Adams MD .

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Editors and Affiliations

  1. Comp Hand Cen. Sec of PS, Dept of Surg, The University of Michigan Health System, Ann Arbor, Michigan, USA

    Kevin C. Chung

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Adams, B.D. (2016). Management of the Distal Radioulnar Joint in Rheumatoid Arthritis. In: Chung, K. (eds) Clinical Management of the Rheumatoid Hand, Wrist, and Elbow. Springer, Cham. https://doi.org/10.1007/978-3-319-26660-2_10

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  • DOI: https://doi.org/10.1007/978-3-319-26660-2_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26658-9

  • Online ISBN: 978-3-319-26660-2

  • eBook Packages: MedicineMedicine (R0)

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