Hemiresection of the distal ulna by means of pronator quadratus interposition and volar stabilization

Abstract

Surgery for ulnar-sided wrist problems have proved a major challenge. A variety of bony procedures, which may or may not be supplemented with soft tissue interposition, tenodesis, and fusion of the distal radioulnar joint, have been designed in an attempt to address this challenge. The problems encountered in the use of these procedures have included weakness, snapping and instability of the distal ulna, pain and impaction, nonunion, and regrowth of bone. To address the instability of the distal ulna and the radioulnar impaction, we have designed an operative technique involving the hemiresection of the distal ulna and the interposition of pronator quadratus (volar stabilization of the distal ulna). This procedure is a safe method for dealing with pain and loss of function due to disorders of the distal radioulnar joint. It provides good pain relief, strength, and motion.