TY - JOUR
T1 - Management of the distal radioulnar joint in rheumatoid arthritis
AU - Lee, Steve K.
AU - Hausman, Michael R.
PY - 2005/12
Y1 - 2005/12
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=27644463417&partnerID=8YFLogxK
U2 - 10.1016/j.hcl.2005.08.009
DO - 10.1016/j.hcl.2005.08.009
M3 - Review article
C2 - 16274868
AN - SCOPUS:27644463417
SN - 0749-0712
VL - 21
SP - 577
EP - 589
JO - Hand Clinics
JF - Hand Clinics
IS - 4
ER -