Surgical Treatment of Distal Radio-Ulnar Joint (DRUJ) Arthritis
Christopher J Dy,
E. Anne Ouellette.
The anatomy of the DRUJ predisposes it to the aggressive synovial destruction characteristic of RA. The DRUJ
relies mainly on soft tissue structures for stability, therefore, the triangular fibrocartilage complex (including the TFC
proper, volar and dorsal radioulnar ligaments, ulnocarpal ligaments, and subsheath of the extensor carpus ulnaris) plays a
substantial role in stabilizing the DRUJ. Early diagnosis and medical treatment of rheumatoid arthritis of the DRUJ is essential
to minimize the bony and soft tissue destruction that occurs as the disease severity worsens. Deformity and instability
at both the radioulnar and ulnocarpal joints should be addressed if surgical management is required. Distal ulnar resection
(Darrach’s procedure) and DRUJ arthrodesis (Sauve-Kapandji procedure) have historically been performed to
treat DRUJ arthritis, but newer interposition arthroplasty and endoprothesis techniques are currently being evaluated.
Keywords: DRUJ, arthritis, surgery, soft tissue
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