Carlson Strother Courtney R, Kakar Sanjeev
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
J Wrist Surg. 2023 Sep 11;13(6):572-577. doi: 10.1055/s-0043-1774330. eCollection 2024 Dec.
Surgical management of the painful, arthritic distal radioulnar joint (DRUJ) remains challenging, particularly in young, active patients. Following exposure of the DRUJ through a dorsal longitudinal incision over the DRUJ, suture anchors are evenly placed around the sigmoid notch. The sutures are threaded through the dermal allograft to secure the graft into the sigmoid notch. The volar edges of the allograft are passed from radial to ulnar underneath the distal ulna and secured to the remaining allograft dorsally, reducing the DRUJ and creating a stable interposition arthroplasty. We present a case report of a young, manual laborer who had significant improvement in pain, range of motion, and grip strength 6 months following interposition arthroplasty at the DRUJ. He was able to return to work after completing his rehabilitation following surgery. Dermal allograft interposition arthroplasty may provide reliable pain relief while maintaining pronosupination and stability of the DRUJ in the appropriately selected patient, without the need for lifting restrictions.
疼痛性关节炎性下尺桡关节（DRUJ）的外科治疗仍然具有挑战性，尤其是对于年轻、活跃的患者。通过在DRUJ上方做一个背侧纵向切口暴露DRUJ后，将缝合锚均匀地放置在乙状切迹周围。缝线穿过真皮同种异体移植物，将移植物固定在乙状切迹中。同种异体移植物的掌侧边缘从桡侧向尺侧穿过尺骨远端下方，并在背侧固定到剩余的同种异体移植物上，复位DRUJ并创建一个稳定的间置关节成形术。我们报告一例年轻体力劳动者的病例，其在DRUJ进行间置关节成形术后6个月，疼痛、活动范围和握力有显著改善。术后完成康复治疗后，他能够重返工作岗位。真皮同种异体移植物间置关节成形术在适当选择的患者中，无需限制提举重物，在维持DRUJ旋前旋后功能和稳定性的同时，可能提供可靠的疼痛缓解。
