Aita Márcio Aurélio, Mallozi Ricardo Carvalho, Ozaki Willian, Ikeuti Douglas Hideo, Consoni Daniel Alexandre Pereira, Ruggiero Gustavo Mantovanni
Faculdade de Medicina do ABC, Santo André, SP, Brazil.
Universidade da Cidade de São Paulo (Unicid), Faculdade de Medicina, Santo André, SP, Brazil.
Rev Bras Ortop. 2018 Feb 23;53(2):184-191. doi: 10.1016/j.rboe.2018.02.010. eCollection 2018 Mar-Apr.
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).
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.
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.
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.
使用肱桡肌（BR）测量接受前臂骨间膜（IOM）韧带重建治疗的患者的生活质量和临床结果，并描述一种治疗桡尺远侧关节（DRUJ）关节不稳的新手术技术。
2013年1月至2016年9月，24例桡尺远侧关节（DRUJ）纵向损伤患者接受了骨间膜远端或远侧斜束（DOB）重建手术治疗。分析临床功能和影像学参数，并描述并发症及重返工作时间。
随访时间为20个月（6 - 36个月）。活动度平均为167.92°（健侧的93.29%）。视觉模拟评分（VAS）为2/10（1 - 6）。上肢功能障碍评分（DASH）为5.63/100（1 - 18）。重返工作时间为7.37个月（3 - 12个月）。至于并发症，1例患者桡尺远侧关节（DRUJ）不稳定，数月后接受了Brian - Adams技术的再次重建。目前，其功能有所改善，并已恢复职业活动。另外3例患者在横行克氏针周围出现问题，经拔除克氏针治疗，均恢复良好。
本研究提出的新方法在治疗桡尺远侧关节（DRUJ）纵向不稳方面安全有效，因为其并发症发生率低，影像学、临床及功能结果均令人满意。它能使患者重返社交和职业活动，提高这些患者的生活质量。
