Erschienen in:
01.12.2014 | Handsurgery
Anatomical transosseous fixation of the deep and superficial fibers of the radioulnar ligaments
verfasst von:
Christian K. Spies, Lars P. Müller, Frank Unglaub, Peter Hahn, Matthias Klum, Johannes Oppermann
Erschienen in:
Archives of Orthopaedic and Trauma Surgery
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Ausgabe 12/2014
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Abstract
Introduction
The triangular fibrocartilage complex is in conjunction with the interosseous membrane the most important stabilizer of the distal radioulnar joint. Lesions of the triangular fibrocartilage complex may cause instability of the distal radioulnar joint with serious consequences. Therefore, the goal is to reconstruct and provide stability to prevent further harm.
Surgical technique
Based on the anatomical configuration of the radioulnar ligaments, we present a technique which addresses both the deep and the superficial fibers of the radioulnar ligaments. This surgical procedure can be performed either openly or arthroscopically assisted. Two osseous 2-mm tunnels starting from the ulnar neck to the foveal surface are created. A nonabsorbable suture is passed through the tunnels and the triangular fibrocartilage using a 20-gauge venipuncture needle in order to attach the deep fibers. Then a third osseous tunnel starting from the lateral base of the styloid process to the medial aspect is created. The suture is passed through this tunnel and through the triangular fibrocartilage and around the styloid process palmarily using the same needle as before in order to anchor the superficial fibers anatomically. After reducing the ulna head the sutures are tightened.
Conclusion
This technique is quite simple and addresses the anatomical configuration of the radioulnar ligaments.