The Operative Treatment of the Unstable Distal Radioulnar Joint using Adam's Technique

Shin, Hyun Dae; Hong, Chang Hwa; Kim, Kyung Cheon; Kim, Kyung Tae; Kim, Tae Hoon

Abstract

PURPOSE
To determine the value of an anatomic distal radio-ulnar joint ligament reconstruction (Adam's technique) in patients who suffer chronic pain related to distal radio-ulnar joint instability. MATERIALS AND METHODS: Twelve patients who suffered from chronic pain related to distal radio-ulnar instability and underwent a reconstruction of the distal radio-ulnar ligament using a free tendon technique were enrolled in this study. The mean follow up period was at least 1 year. In all cases, injury to the distal radio-ulnar joint was present, which had been previously treated with conservatively. There was no evidence of arthritis on the distal radio-ulnar joint radiologically. The radiological radio-ulnar space and displacement of the ulnar head, clinical pain, stability, the range of motion and the grip power were measured before and after surgery (follow up 1 year). RESULTS: No displacement of the distal radio-ulnar joint or prominence of the ulnar head was observed radiologically in 10 cases, and only partial subluxation was present in 2 cases. Clinically, the pain disappeared in 8 cases and the stability of the joint was recovered in 8. The mean pronation, supination range and grip power increased by an average of 73, 71 degrees and 11.7 kg, respectively. CONCLUSION: In treating distal radio-ulnar joint instability related to chronic pain, Adam's technique using palmaris longus, which is an operation using a single incision, and by restoring the distal radio-ulnar ligament anatomically can decrease the level of pain and recover the range of motion. Therefore, it is a good method worth considering in this situation.