Medium- to long-term outcomes of anatomical reconstruction of the radioulnar ligament to the ulnar fovea

• Published in: The Journal of hand surgery, European volume Vol. 42; no. 4; p. 352
• Main Authors: Nakamura, T, Abe, K, Nishiwaki, M, Iwamoto, T, Sato, K
• Format: Journal Article
• Language: English
• Published: England 01.05.2017
• Subjects: Adult; Aged; Arthroscopy; Female; Humans; Joint Instability - etiology; Joint Instability - surgery; Ligaments, Articular - surgery; Male; Middle Aged; Retrospective Studies; Time Factors; Treatment Outcome; Triangular Fibrocartilage - injuries; Wrist Injuries - complications; Wrist Injuries - surgery; Young Adult; extensor carpi ulnaris; interference screw; anatomical reattachment; Triangular fibrocartilage complex; long-term follow-up
• ISSN: 2043-6289
• DOI: 10.1177/1753193416679625

We examined the medium- to long-term outcome of the original reconstruction technique of the radioulnar ligament using a half-slip of the extensor carpi ulnaris tendon for chronic foveal avulsion of the triangular fibrocartilage complex. We treated 37 wrists in 36 patients with a minimum follow-up of 5 years. Of 36 patients, 12 had more than 10 years follow-up. At final follow-up, 30 patients (31 wrists) reported no pain, five patients (five wrists) reported mild occasional pain and one patient reported severe persistent pain. Two patients had lost 30° of supination. Complete stability of the distal radio-ulnar joint was achieved in 31 wrists, moderate instability was noted in five and severe distal radio-ulnar joint instability remained in one. The size of the bone tunnel was assessed radiologically: in two it had enlarged; in 23 it was unchanged; and in 12 it appeared to have closed over the tendon graft. The overall clinical outcomes were 28 excellent, four good, four fair and one poor. The 12 wrists with more than 10 years follow-up had seven excellent, three good and two fair clinical results. This reattachment technique appears to work and last over the medium- to long-term. IV.