Ulnar head arthroplasty with posterior interosseous nerve ne
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.

Published in the International Journal of Surgery Case Reports, the authors present a 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 MRI showed degenerative changes in the radiocarpal joint and distal radioulnar joint. In order to preserve the remaining mobility and reduce the wrist pain the authors 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.

• Distal radioulnar joint arthropathy has multiple causes

• Ulnar head excision results in wrist instability and a weak improvement of pain

• Ulnar head arthroplasty is a safe and effective procedure

• Posterior interosseous nerve neurectomy decreases wrist pain but not proprioception

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