DRUJ Reconstruction 25676

• synonyms:
• CPT = 25676 Open treatment of distal radioulnar joint dislocation, acute or chronic

DRUJ Reconstruction Anatomy

• DRUJ dislocations are classified based on the direction the ulnar head moves in relation to the radius.  In reality, the unla is the stationary bone in the forearm and the radius, wrist and hand rotate or dislocate around it. 

DRUJ Reconstruction Indications

• Pain, +/- snapping of the DRUJ secondary to DRUJ instability

DRUJ Reconstruction Contraindications

• Acute DRUJ dislocation
• Radius or ulnar malunion or malalignment
• DRUJ arthritis
• Ulnar positive variance
• Rheumatoid arthritis
• Ehler-Danlos-like laxity

DRUJ Reconstruction Alternatives

• Radiolunate arthrodesis

DRUJ Reconstruction Pre-op Planning / Special Considerations

• fully evaluate for concomittant injuries: TFCC tear, Galeazzi fracture-dislocation, Essex-Lopresti injuries.

DRUJ Reconstruction Technique

• Sign operative site
• Pre-op antibiotics
• well padded tourniquet place high in the arm
• prep and drape in standard sterile fashion
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• Possible interposed structures: tendon and shealth of the ECU
• K-wire may in inserted from the ulna to the radius just proximal to the joint if reduction is unstable in forearm positions.

 DRUJ Reconstruction Complications

DRUJ Reconstruction Follow-up care

DRUJ Reconstruction Outcomes

DRUJ Reconstruction Review References

• Adams BD, Berger RA. An anatomic reconstruction of the distal radioulnar ligaments for posttraumatic
  distal radioulnar joint instability. J Hand Surg [Am]. 2002;27:243-51.
• Chidgey LK, JAAOS 1995;3:95