Abstract
Introduction and Aims: Distal radioulnar joint surgery in the past have been dominated by different types of partial or complete ulnar head excision. However, in the long run this can create a number of problems; hence we have used Herbert modular prosthesis to tackle these very difficult situations. This prosthesis comprises of a press fit stem in three sizes and a ceramic head also available in three sizes.
Method: In Wrightington Hospital upper limb unit, 61 patients underwent Herbert ulnar head replacement. Fifty-eight were clinically and radiologically reviewed. This is the largest series from a single centre of this type of surgery.
Between December 1998 and December 2002, 21 male and 27 female patients were operated. The mean age was 49.8 (range 28–72 years). Twenty-two left, eighteen right and two bilateral replacements were performed. The mean follow-up was 20.02 months (range 3–60 months).
An independent observer, using range of motion, grip strength and satisfaction as outcome, reviewed all patients.
Results: Primary diagnoses included failed Darrach, Bower, Sauve Kapandji and traumatic ulnar head excision. Forty-five patients were satisfied with the outcome. Pain score showed a mean improvement of four, with a range of 0–10. The grip strength compared to normal side was decreased in 50% of the patients. The range of motion compared to normal side improved by a mean of 10 degrees (range 3–20) in supination and 13 (range 4–23) in pronation.
Conclusion: Radiological review showed new bone (eight) and notch formation (nine). Stress shielding of 0–19mm was observed in distal ulna with revision or emergency stem. Complication occurred in eight patients: instability (four), RSD (one), implant failure (one) and two others. Twelve patients required further surgery. No loosening was observed at revision. There are no long-term results available at present.
These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.
At least one of the authors is receiving or has received material benefits or support from a commercial source.
