HIT) for the treatment of distal Radio-Ulnar joint Derangement

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Journal of the Korean Society for Surgery of the Hand 1996;1(1):66-73.
Published online January 1, 1996.

Seung Koo Rhee,Hyung Min Kim,Suk Whan Song,Wha Sung Lee,Kyung Ho You

원위 요-척 관절의 장애에 대한 관절 성형술 Hemiresection Interpositional Arthroplasty

이승구,김형민,송석환,이화성,유경호

Abstract

Chronic derangement of the distal radio-ulnar joint(DRUJ) are not uncommon, but they are often neglected to be treated and became painful wrists. In 1984, Palmer and Werner reported that approximately 81.6% of the load applied on a wrist model was borne by the distal radius and 18.4% by the distal ulna, thus ulnar variance will change the load borne by the distal ulna, with the DRUJ playing an important role in the integrated forearm-wrist-hand-function biomechanically, To find out the biomechanical significance of the DRUJ, we have analysed the end results of total 32 cases of chronic derangement of DRUJ which were treated by reconstruction (HIT), resection of distal ulna (Darrach operation) and Sauve-kapandji operation since 1980, and followed them for at least 5 years after surgery. The results ohtained were as follows: 1. There was marked postoperative improvement in wrist pain, range of motion, and grip strength in all 32 cases: 2. In comparing the long-term follow-up results between the HIT group(19 cases), Darrach operation(10 cases) and Sauve-kapandji operation group(3 cases), relief from pain was marked in the former, while the range of motion and grip strength scores were similar in both groups. It was concluded that the distal ulnar head and DRUJ were singularly important in preservation of normal wrist function. While various methods of treatment of DRUJ derangement are available, the results of reconstruction surgery(HIT) in long term follow up are more favorable than those of the Darrach or Sauve-Kapandji operation.

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