Publicação
Ulnar Head Arthroplasty with Posterior Interosseous Nerve Neurectomy: A Case Report
| Resumo: | BACKGROUND: Distal Radioulnar joint (DRUJ) arthropathy can occur as a consequence of multiple mechanisms, including trauma, inflammatory or degenerative arthritis or even congenital anomalies. Ulnar head arthroplasty has been proposed as a viable therapeutic option, potentially restoring wrist function and improving pain control. This can also be achieved by complete wrist neurectomy but it has several risks associated with the procedure. A selective neurectomy may be more effective. CASE PRESENTATION: We report the case of a 51-year-old man, Tool-Colector, who suffered from constant diffuse left wrist pain aggravated with activities and had a swollen and tender wrist at physical examination with limited range of motion on prono-supination. Radiographic and magnetic resonance imaging showed degenerative changes in the radiocarpal joint and distal radioulnar joint. In order to preserve the remaining mobility and reduce the wrist pain we proceeded with an ulnar head arthroplasty and a posterior interosseous nerve neurectomy, through a single skin incision in the dorso-ulnar side of the wrist. Afterwards, the patient followed a strict rehabilitation program with a hand therapist. Six months later he returned to his previous job with no limitations. CONCLUSIONS: Ulnar head arthroplasty seems to be a very good option in the treatment of severe DRUJ arthrosis. It significantly improves pain control while maintains or even improves range of motion. Posterior interosseous nerve neurectomy is a simple technique and highly effective. |
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| Autores principais: | Mata Ribeiro, L |
| Outros Autores: | Botton, M |
| Assunto: | CHLC CPR Distal Radioulnar Arthroplasty Distal Radioulnar Joint Posterior Interosseous Nerve Neurectomy Ulnar Head Arthroplasty Ulnar Head Implant |
| Ano: | 2018 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Centro Hospitalar de Lisboa Central, EPE (CHLC) |
| Idioma: | inglês |
| Origem: | Repositório do Centro Hospitalar de Lisboa Central, EPE |
| Resumo: | BACKGROUND: Distal Radioulnar joint (DRUJ) arthropathy can occur as a consequence of multiple mechanisms, including trauma, inflammatory or degenerative arthritis or even congenital anomalies. Ulnar head arthroplasty has been proposed as a viable therapeutic option, potentially restoring wrist function and improving pain control. This can also be achieved by complete wrist neurectomy but it has several risks associated with the procedure. A selective neurectomy may be more effective. CASE PRESENTATION: We report the case of a 51-year-old man, Tool-Colector, who suffered from constant diffuse left wrist pain aggravated with activities and had a swollen and tender wrist at physical examination with limited range of motion on prono-supination. Radiographic and magnetic resonance imaging showed degenerative changes in the radiocarpal joint and distal radioulnar joint. In order to preserve the remaining mobility and reduce the wrist pain we proceeded with an ulnar head arthroplasty and a posterior interosseous nerve neurectomy, through a single skin incision in the dorso-ulnar side of the wrist. Afterwards, the patient followed a strict rehabilitation program with a hand therapist. Six months later he returned to his previous job with no limitations. CONCLUSIONS: Ulnar head arthroplasty seems to be a very good option in the treatment of severe DRUJ arthrosis. It significantly improves pain control while maintains or even improves range of motion. Posterior interosseous nerve neurectomy is a simple technique and highly effective. |
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