Change of wrist motion before and after fixation of the distal radioulnar joint and resection of the distal ulna in a cadaveric model

Abstract

Objective: Recent study suggests the distal radioulnar joint (DRUJ) plays a role in flexion and extension of the wrist. We examined the range of motion (ROM) of the wrist before and after DRUJ fixation and distal ulnar resection in a cadaveric model.

Methods: Twenty fresh cadaveric human wrists were transected and treated with two sequential interventions: (a) DRUJ fixation, and (b) distal ulnar resection. The angle of maximum flexion and extension of the wrist was measured before and after the procedures. Maximum force to the wrist was determined before the procedures using a digital pressure monitor.

Results: The mean maximum wrist flexion ROM was 84.2° before the procedures. The ROM decreased to 82.5° after DRUJ fixation, and significantly increased to 88.2° after subsequent resection of the distal ulna. The mean maximum wrist extension ROM before the procedures was 73.5°. The ROM decreased to 71.6° after DRUJ fixation, and significantly increased to 77.1° after subsequent resection of the distal ulna.

Conclusions: Motion of the wrist is affected by DRUJ. This study suggests that the DRUJ might contribute to the ROM in flexion and extension of the wrist.

Keywords: Cadaveric study; Darrach procedure; Sauvé-Kapandji procedure; distal radioulnar joint; wrist biomechanics.