Abstract
We studied the outcome of patients with chronic distal radioulnar joint symptoms who were treated with excision of the distal ulna and reconstruction using the flexor carpi ulnaris tendon. Twelve patients with 14 wrists were assessed. Ten patients were posttraumatic, and two had bilateral surgery for rheumatoid arthritis. Average age was 37 years at time of operation. Follow-up averaged 20 months (9 months to 4 years). All patients except one reported improvement in pain symptoms. Grip strength of the operated hand as measured by dynamometer readings was 67% of the strength of the normal hand with five wrists achieving an excellent result in grip strength. Eleven patients reported a subjective improvement in functional activities. An improved range of motion was obtained in all patients. We discuss the importance and basis for ligamentous reconstruction following excision of the distal ulna and review the literature for other previously described procedures.
Résumé
Nous avons étudié le résultat de malades souffrant de symptômes chroniques de l'articulation radio-ulnaire distale qui ont été traité par excision du cubitus distal et reconstruction avec le tendon du fléchisseur carpien ulnaire. Un total de douze malades avec quatorze poignets ont été étudiés. Dix étaient post traumatiques et deux ont eu une chirurgie bilatérale pour polyarthrite rhumatoïde. L'âge moyen était de 37 ans à l'opération. Le suivi moyen était de 20 mois (neuf mois à quatre années). Tous les malades sauf un ont eu une amélioration de la douleur. La force de préhension, mesurée par dynamomètre, était de 67% de celle de la main normale et 5 des 14 poignets ont obtenus une force de très bonne qualité. Une amélioration de la mobilité a été obtenue chez tous les patients. Onze des douze malades ont rapporté une amélioration subjective dans les activités quotidiennes. Les auteurs discutent l'importance de la reconstruction ligamentaire après résection distale du cubitus.
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