OKOJ, Volume 1, No. 8

Distal radioulnar joint instability is characterized by increased anteroposterior joint translation, varying from subluxation to complete dislocation.Distal radioulnar joint (DRUJ) instability most commonly occurs in conjunction with a distal radius fracture. Up to 30 percent of distal radius fractures have persistent ulnar-sided symptoms, with many caused by DRUJ instability. Distal radioulnar joint instability usually results from a combined rotational and axial force to the forearm and the most common cause for DRUJ instability is a distal radius fracture.

This article presents the pathophysiology and clinical diagnosis of chronic istability of the distal radioulnar joint, and reviews surgical management options indepth. Techniques reviewed in deatil include TFCC open repair and distal radioulnsar ligament reconstruction. Video is available.

De Quervain's disease is a stenosing tendovaginitis of the first dorsal compartment of the wrist. Tendovaginitis refers to the inflamed and thickened retinacular sheath, which is characteristic of de Quervain's disease. De Quervain's disease classically affects those who are in their forties and fifties. The incidence in women may be up to six more times more common than in men. The process is aggravated by activities that require frequent and repetitive abduction and simultaneous ulnar deviation at the wrist. The diagnosis is usually easily made after eliciting a history of radial-sided wrist pain aggravated by thumb movement.

The pathophysiology and clinical presentation of de Quervain's disease are reviewed, and the nonsurgical and surgical management options are reviewed in detail, including the first dorsal compartment release.