Management of the distal radioulnar joint in rheumatoid arthritis

Steve K. Lee, Michael R. Hausman

Research output: Contribution to journalReview articlepeer-review

29 Scopus citations

Abstract

The DRUJ frequently is involved in RA and can be a source of major disability. Nonoperative treatment consists of adequate hand/occupational therapy, judicious splinting, and pharmacologic management. If unacceptable pain and dysfunction persists or if there is tendon rupture, surgery is indicated. Surgical treatment ranges from debridement and soft tissue balancing if the joint is preserved to osseous procedures ranging from Darrach resection, Sauve-Kapandji procedure, hemiresection, to distal ulna replacement. Tendon ruptures usually require tendon transfers. If an osseous procedure is required, the authors prefer the Sauve-Kapandji procedure in the younger, active adult. Darrach distal ulna resection is recommended for the older, sedentary patient. For either procedure, if there is evidence of pre-existing radiocarpal instability, partial or total wrist arthrodesis or arthroplasty should be a concomitant procedure.

Original languageEnglish
Pages (from-to)577-589
Number of pages13
JournalHand Clinics
Volume21
Issue number4
DOIs
StatePublished - Dec 2005

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