Ligamentous reconstruction of the interosseous membrane of the forearm in the treatment of instability of the distal radioulnar joint

Abstract

Objectives

To measure the quality of life and clinical outcomes of patients treated with interosseous membrane (IOM) ligament reconstruction of the forearm, using the brachioradialis (BR), and describe a new surgical technique for the treatment of joint instability of the distal radioulnar joint (DRUJ).

Methods

From January 2013 to September 2016, 24 patients with longitudinal injury of the distal radioulnar joint DRUJ were submitted to surgical treatment with a reconstruction procedure of the distal portion of the interosseous membrane or distal oblique band (DOB). The clinical-functional and radiographic parameters were analyzed and complications and time of return to work were described.

Results

The follow-up time was 20 months (6–36). The ROM averaged 167.92° (93.29% of the normal side). VAS was 2/10 (1–6). DASH was 5.63/100 (1–18). The time to return to work was 7.37 months (3–12). As to complications, one patient had an unstable DRUJ, and was submitted to a new reconstruction by the Brian-Adams technique months. Currently, he has evolved with improved function, and has returned to his professional activities. Three other patients developed problems around the transverse K-wire and were treated with its removal, all of whom are doing well.

Conclusion

The new approach presented in this study is safe and effective in the treatment of longitudinal instability of the DRUJ, since it has low rate of complications, as well as satisfactory radiographic, clinical, and functional results. It allows return to social and professional activities, and increases the quality of life of these patients.