Total distal radioulnar joint replacement for symptomatic joint instability or arthritis

Total distal radioulnar replacement differs from conventional treatment because it involves replacing all 3 components of the distal radioulnar joint. The aim of the procedure is to increase stability of the joint and improve pain-free movement.

The procedure is done with the patient under general or regional anaesthesia, and with a tourniquet applied to the upper arm. Radiological screening is used during the procedure to check the position of the joint. An incision is made along the ulnar border and the ulnar head is removed, taking care to avoid damage to the ulnar nerve, tendons and artery. A plate bearing a socket is fixed to the radius, and the ulna component of the prosthesis is then inserted and attached to the radial component, using a ball to allow pronation and supination. The range of motion of the joint is checked and the wound is closed. Patients are usually encouraged to start full range-of-motion exercises about 2 weeks after the procedure.