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Artroplastia de Hemirressureição da Articulação Distal Rádio-Ulnar

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Um plano de recuperação após artroplastia de hemirresssecção-interposição da articulação radioulnar distal, onde a parte desgastada da cabeça ulnar é parcialmente removida para restaurar a rotação do antebraço sem dor; após um breve período de proteção, a rotação precoce do antebraço (virar a palma para cima e para baixo) é a prioridade, com cargas mais pesadas sendo adicionadas gradualmente.

Ilustração de despejar de uma chaleira, a ação cotidiana que requer rotação do antebraço sem dor.
A articulação radioulnar distal permite a rotação do antebraço, virando a palma para cima e para baixo, como ao despejar água de uma chaleira. A hemirresssecção alivia uma articulação dolorosa e desgastada, mantendo essa rotação. Kieran Hirpara 4.0

Esta página foi traduzida automaticamente e ainda não foi verificada por um médico. A versão em inglês é a versão oficial.

Este protocolo orienta a sua recuperação após a artroplastia de hemirresssecção com interposição da articulação radioulnar distal (ARUD), uma cirurgia que remodela a extremidade desgastada do antebraço para restaurar a rotação confortável e sem dor do antebraço, com o Dr. Kieran Hirpara no Mater Private Hospital Rockhampton. Ele começa com o seu programa de exercícios domiciliares, seguido pelo protocolo clínico estruturado escrito para o seu fisioterapeuta da mão; leve esta página ou o seu PDF à sua primeira sessão de terapia para que a reabilitação permaneça coordenada. O seu terapeuta pode ajustar o plano dependendo de como a sua recuperação progride.

Se tiver alguma preocupação sobre a sua ferida após a cirurgia, entre em contato com a clínica. Frequentemente, é útil tirar uma foto da ferida e enviá-la por e-mail para avaliação.

O que esperar

A articulação radioulnar distal (ARD) é a pequena articulação próxima ao pulso, no lado do dedo mínimo, onde os dois ossos do antebraço (o rádio e a ulna) se encontram. É a articulação que permite girar o antebraço, com a palma para cima (supinação) e com a palma para baixo (pronação). Quando esta articulação se desgasta e se torna artrítica, o giro do antebraço torna-se doloroso.

Numa artroplastia de hemirresssecção, apenas a parte desgastada e artrítica da cabeça da ulna é lixada (uma remoção parcial: "hemi" significa metade), e um pequeno coxim do seu próprio tecido mole é introduzido no espaço para evitar o atrito entre as superfícies. Esta operação preserva as estruturas estabilizadoras principais, incluindo o TFCC (a rede de cartilagem e ligamentos que suporta o pulso nesse lado), o estiloide ulnar e as inserções dos tecidos moles, de modo que a extremidade da ulna permanece suportada. É isto que a diferencia da remoção completa da cabeça da ulna (procedimento de Darrach).

Como as superfícies articulares são remodeladas em vez de reparadas ou reconstruídas, não há tendão ou ligamento que precise de cicatrizar sob proteção durante meses. O objetivo desta operação é a rotação do antebraço sem dor, e a parte mais importante da sua reabilitação é iniciar precocemente esse movimento de rotação. Após um breve período de proteção com uma tala para permitir que os tecidos moles se estabilizem, a recuperação do giro do antebraço (palma para cima e palma para baixo) torna-se o foco principal da sua recuperação. A força e as cargas mais pesadas são adicionadas gradualmente posteriormente.

Precauções e limitações

  • Durante as primeiras duas a três semanas, use o seu talhe conforme indicado; ele limita suavemente a rotação do antebraço enquanto o tecido interposto se estabiliza. Mantenha os dedos e (quando autorizado) o pulso em movimento.
  • Uma vez autorizado a sair do talhe, priorize a rotação do antebraço, mantendo-a sem dor e sem carga. A rotação inicial deve ser feita com a mão vazia, não contra resistência.
  • NÃO carregue o antebraço em rotação precocemente: evite abrir potes torcendo, torcer panos, usar chave de fenda ou carregar sacolas pesadas desse lado até que o fortalecimento seja autorizado (comumente entre seis e oito semanas).
  • Este-se atento à dor ou sensação de instabilidade no lado do dedo mínimo do pulso ao empurrar ou carregar através do antebraço, pois esta é a área onde a cirurgia atuou. Informe-o ao seu terapeuta da mão; não force através dela.
  • Mantenha os dedos, o polegar, o cotovelo e o ombro em movimento livre desde o início, e use a mão para tarefas diárias leves dentro do conforto, desde que não envolvam torção forçada ou com carga.

Para o cuidado da ferida, controle do inchaço e manejo da cicatriz, consulte as orientações da prática sobre cuidados com a ferida.

Seus exercícios

Estes são os exercícios do seu material informativo. Inicie-os apenas conforme orientado pelo Dr. Hirpara e pelo seu terapeuta da mão, mantendo-se dentro da amplitude e dos limites que lhe foram indicados. O movimento dos dedos começa imediatamente. A rotação do antebraço (o exercício em torno do qual toda esta cirurgia é baseada) e o movimento do punho iniciam-se quando você for liberado para sair da tala, geralmente entre duas a três semanas, e a rotação passa então a ser o seu foco principal. A massagem na cicatriz começa quando a ferida estiver completamente cicatrizada. O fortalecimento da pegada e da rotação pertence a uma fase posterior e não deve ser iniciado até que você receba liberação específica para tal. Interrompa qualquer atividade que cause dor aguda no lado do dedo mínimo do punho.

Seu protocolo clínico

O restante desta página é o protocolo clínico em fases para a reabilitação após artroplastia de hemirresssecção com interposição da articulação radioulnar distal. Esta seção deve ser fornecida ao seu terapeuta da mão, e cada fase inicia-se com uma explicação em linguagem simples do que está ocorrendo. Este é um procedimento de remodelação articular (artroplastia), e não de reparo: não há uma construção sob tensão a ser protegida por meses. A restrição deliberada é breve: um curto período de imobilização com talha para permitir que a interposição de tecidos moles e a cápsula se estabilizem, após o qual a restauração precoce da rotação do antebraço é a prioridade explícita, pois a rotação é a função que a operação visa restaurar. A principal carga a ser respeitada ao longo de todo o processo é o carregamento rotacional da ulna distal, que é o que provoca a instabilidade dolorosa do coto ulnar e a convergência radioulnar.

Antes do tratamento, verifique o relatório cirúrgico do paciente e seu histórico médico, e entre em contato com o cirurgião assistente quanto a quaisquer procedimentos concomitantes (reparo do TFCC, osteotomia do rádio distal, neurectomia do nervo interósseo posterior, reconstrução dos extensores), à estabilidade do coto ulnar distal avaliada intraoperatoriamente e à talha prescrita e ao limite de rotação. Um reparo concomitante do TFCC ou uma osteotomia do rádio distal prolongam a fase protegida; uma hemirresssecção isolada para artrise degenerativa ou pós-traumática segue o caminho mais curto descrito abaixo. O Dr. Hirpara preserva o TFCC, o estiloide ulnar e os anexos moles ulnares, de modo que a ulna distal permanece suportada, e a reabilitação pode, portanto, priorizar a rotação precoce.

Fase I — proteção e estabilização em talas (semanas 0 a 2-3)

As primeiras duas a três semanas protegem a interposição dos tecidos moles e a cápsula, mantendo o resto do membro móvel. O antebraço é mantido em uma tala (comumente uma tala ou gesso acima do cotovelo, tipo Muenster, que limita a rotação do antebraço), removida apenas para higiene e, no final da fase, para a primeira rotação suave. Os dedos se movem desde o primeiro dia.

Para o seu terapeuta da mão:

Educação e precauções - Imobilizar na tala prescrita (acima do cotovelo, tipo Muenster, ou conforme o cirurgião), limitando a rotação do antebraço; removida apenas para higiene e exercícios liberados - Sem rotação do antebraço com carga; sem apoio de peso ou torção através do antebraço operado - Reassegurar que a fraqueza inicial da pegada e o inchaço no lado ulnar são esperados

Conduta - Ferida: curativos cirúrgicos conforme orientação; monitorar sinais de infecção - Edema: elevação, bombeamento suave da mão, gelo conforme necessário - Exercícios: mobilidade ativa (ROM) dos dedos, do polegar e (se não bloqueada pela tala) do ombro desde o primeiro dia; mobilidade suave do cotovelo conforme a tala permitir; introduzir rotação ativa suave, sem dor, do antebraço nos últimos dias desta fase, se o cirurgião permitir a remoção precoce

Critérios para progressão - Estabilização da ferida; período de tala (≈2-3 semanas para hemirressessão isolada) concluído; liberado pelo cirurgião para rotação ativa

Fase II — rotação precoce do antebraço (a prioridade) (semanas 2-3 a 6)

Esta é a fase definidora. Fora da tala, a pronação e supinação ativas tornam-se o foco principal da reabilitação: suaves, frequentes, sem dor e sem carga. O movimento do punho é adicionado. A rotação é a função restaurada pela cirurgia, por isso é trabalhada ativamente nesta fase, enquanto a carga ainda é evitada.

Para o seu terapeuta da mão:

Avaliações - Pronação/supinação ativa e passiva do antebraço (restauração alvo em direção aos ~80° em cada direção relatados nas séries de resultados); amplitude de movimento (AM) do punho e dos dedos; dor na ulna do punho; edema; revisão da ferida/cicatriz

Educação e precauções - A rotação do antebraço é a prioridade: pronação/supinação ativa frequente, sem dor e sem carga, com o cotovelo junto ao tronco para isolar o antebraço - Sem rotação resistida ou com carga, sem preensão forte e sem tarefas de torção até ~6-8 semanas - Algumas talas limitam ainda mais a rotação no final da amplitude por algumas semanas após a remoção do gesso; respeite qualquer limite prescrito

Conduta - Exercícios: pronação/supinação ativa e ativa-assistida como foco principal; flexão/extensão ativa do punho e desviação radial/ulnar; continuar a AM dos dedos e preensão (sem preensão resistida ainda); iniciar o manejo da cicatriz assim que a ferida estiver completamente cicatrizada - Modalidades para edema e cicatriz conforme necessário

Critérios para progressão - Rotação ativa do antebraço próxima da amplitude total, controlada e sem dor; ferida cicatrizada; dor ≤3/10; sem dor provocativa no lado ulnar durante a rotação suave

Fase III — fortalecimento e retorno (semanas 6-8 e além)

Assim que a rotação for restaurada e indolor, o fortalecimento começa e é progressivamente intensificado: primeiro o grip, depois a rotação do antebraço com carga, observando especificamente a instabilidade dolorosa do toco ulnar ou a convergência radioulnar sob carga. O retorno a atividades mais pesadas e ao esporte é baseado em critérios.

Para o seu terapeuta da mão:

Avaliações - Força de grip em comparação com o lado oposto (relatório da série de resultados indica recuperação em direção a ~85-90% do lado contralateral); força de rotação do antebraço e qualquer dor ou instabilidade na rotação com carga; testes funcionais e específicos para trabalho/esporte, conforme apropriado

Educação e precauções - Introduzir o grip resistido primeiro, depois a rotação do antebraço com carga graduada (por exemplo, movimentos de martelo com peso leve) a partir de cerca de seis a oito semanas; aumentar a carga lentamente - Observar instabilidade dolorosa do toco ulnar / convergência radioulnar sob carga axial ou rotacional: se provocada, reduzir a carga e comunicar-se com o cirurgião

Conduta - Exercícios: grip progressivo/trabalho com massa de modelar; pronação/supinação resistida graduada (leve → moderada); carga específica para tarefas; continuar qualquer trabalho de ROM residual - Considerar a alta quando a rotação e o grip forem funcionais e quase simétricos, e for alcançado um retorno adequado da função - Considerar a remissão de volta ao médico assistente se a recuperação estagnar, ou se houver dor persistente ao carregar o lado ulnar sugerindo instabilidade do toco ou convergência

Critérios para retorno à carga/esporte - Força de grip e rotação quase simétrica; rotação com carga sem dor; sem instabilidade nos testes funcionais

Retornar ao trabalho e às atividades

O uso leve das mãos nas atividades diárias (comer, escrever, cuidados pessoais leves) é incentivado desde o início, dentro dos limites do conforto, desde que não envolva torção forçada ou sob carga do antebraço. Como o antebraço é imobilizado precocemente e você precisa ser capaz de controlar o volante com segurança (incluindo girá-lo), planeje ajuda para o transporte nas primeiras semanas; a direção do veículo só é retomada quando você sai da tala e consegue girar o antebraço com conforto e segurança para fazer a direção, conforme confirmado na sua consulta de acompanhamento.

Tarefas que exigem torção sob carga (abrir potes difíceis, torcer panos, usar chave de fenda, carregar sacolas pesadas desse lado) só devem ser realizadas após liberação para fortalecimento (comumente por volta de seis a oito semanas) e devem ser introduzidas gradualmente. O retorno a trabalhos manuais mais pesados e à prática esportiva segue a mesma progressão baseada em critérios e depende da recuperação da rotação do antebraço e da força de preensão sem dor, próximas da simetria, avaliadas pelo Dr. Hirpara e pelo seu terapeuta da mão, e não apenas pelo calendário.

Após o seu protocolo

Este protocolo complementa as orientações gerais de recuperação da clínica; consulte o manejo da dor pós-operatória, o cuidado com a ferida e o manejo da cicatriz. Se o seu problema na articulação radioulnar distal (DRUJ) tiver sido consequência de uma fratura do punho, o protocolo de fixação da fratura do rádio distal é um complemento útil. O plano em fases acima reflete as orientações de reabilitação publicadas após a artroplastia de hemirresssecção da articulação radioulnar distal, e a sua recuperação contínua é orientada individualmente pelo Dr. Hirpara e pelo seu terapeuta da mão, de acordo com a evolução do seu antebraço.

Reviewed by Dr Kieran Hirpara · 21 June 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

DRUJ Hemiresection-Interposition Arthroplasty (Bowers) — Procedure Outcomes & Post-operative Rehabilitation

Topic scope: post-operative rehabilitation after hemiresection-interposition arthroplasty (HIT) of the distal radioulnar joint (DRUJ) — the Bowers procedure — for painful DRUJ arthritis (degenerative, post-traumatic, or inflammatory). The arthritic portion of the ulnar head is partially resected and a soft-tissue spacer is interposed, preserving the TFCC, ulnar styloid and ulnar soft-tissue attachments so the distal ulna remains supported. This is a joint-reshaping arthroplasty, not a repair or reconstruction: the rehab is therefore an early-rotation pathway built around a short protected settling phase, then prioritised restoration of forearm pronation/supination, then graded loading — not months of construct protection.

Defining principle of the rehab here: the operation exists to restore pain-free forearm rotation, and nothing is sutured under tension that must heal protected for months. The deliberate restraint is a brief splinted phase (commonly an above-elbow / Muenster-type splint limiting forearm rotation for ~2-3 weeks in the isolated case) to let the soft-tissue interposition and capsule settle. After that, early active pronation/supination is the explicit priority — rotation is the function the operation restores. The single load to respect throughout is rotational/axial loading of the distal ulna, which provokes the characteristic failure mode: painful ulnar-stump instability and radioulnar convergence. The main branch point that lengthens the protected phase is a concurrent procedure (TFCC repair, distal radius osteotomy, extensor reconstruction).

A. PROCEDURE OUTCOMES (hemiresection-interposition arthroplasty)

The Bowers HIT is a long-established, generally reliable salvage for the arthritic DRUJ. The evidence base is level IV (retrospective cohorts and case series, no randomised trials), but it is consistent across decades: most patients gain durable pain relief and improved, stable forearm rotation, with the principal residual concern being ulnar-stump instability / radioulnar convergence under load.

  • The original Bowers series established the procedure and its rationale. Bowers' 1985 description (38 patients, mean ~2.5 yr) reported stable, painless rotation in the great majority — in rheumatoid patients ~85% achieved stable painless rotation (pronation ~84°, supination ~77°), and degenerative/post-traumatic patients achieved painless rotation averaging ~80° in each direction. The technique was explicitly designed to preserve the functional ulnocarpal ligament complex [Bowers, J Hand Surg Am 1985]. Level IV (foundational case series).
  • Long-term outcomes are durable but with a defined complication rate. A long-term cohort (66 patients, mean follow-up 8.6 years) reported low residual pain (median NRS 1/10), an overall complication rate of ~14% and reoperation ~8%; reported complications included stylocarpal impingement, ulnar subluxation, exostoses and tendon rupture. Inflammatory-arthritis patients had lower pain than post-traumatic patients (median 0 vs 5). The same series found PIN neurectomy associated with improved pain scores [HIT long-term outcome study, Hand (N Y) 2019]. Level IV (cohort).
  • Forearm rotation, grip and pain all improve measurably. A capsuloretinacular HIT series (21 wrists, mean ~2 yr 10 mo) reported significant gains: pronation 56.8°→83.0°, supination 60.0°→82.0°, grip 66.0%→87.4% of the contralateral side, VAS pain 62→23 mm, DASH 37.7→25.0, PRWE 48.1→24.4, with no post-operative DRUJ instability reported in that series [HIT capsuloretinacular series, J Wrist Surg 2023]. Level IV (cohort).
  • HIT sits within a family of DRUJ salvage options (Darrach distal ulna resection, Sauvé-Kapandji arthrodesis-pseudarthrosis, matched/hemiresection variants, and ulnar-head implant arthroplasty), each with its own instability/convergence profile; HIT's selling point is preservation of the ulnar support structures to reduce stump instability versus a formal Darrach [Bowers 1985; Glowacki, Hand Clin 2005; Chidgey, JAAOS 1995; Rekant, Hand Clin 2012; Murray, Hand Clin 2011]. Mechanistic / narrative-review.

B. REHABILITATION / THERAPY EVIDENCE

There is no trial-level evidence for any specific rehabilitation regimen after DRUJ HIT. Protocols are surgeon- and technique-derived expert consensus, reported as the post-operative methods of the outcome series and operative-technique articles above. The consensus is consistent on its key features.

  • A brief protected settling phase, not prolonged immobilisation. In the isolated hemiresection (no distal radius osteotomy, no TFCC repair), a long-arm plaster splint for ~10 days followed by a removable Muenster splint for a further 2-3 weeks is typical; cohort series report an upper-arm cast ~3 weeks then a forearm cast 1-2 weeks. Where a distal radius osteotomy or TFCC repair is added, immobilisation is longer (e.g. a long-arm cast in ~45° supination for ~4 weeks) [Pillukat & van Schoonhoven, Oper Orthop Traumatol 2009; HIT capsuloretinacular series, J Wrist Surg 2023]. Weak / expert consensus.
  • Early forearm rotation is the explicit priority once protection ends. The whole point of the operation is rotation, so active pronation/supination is pursued early and frequently. Some protocols further limit end-range rotation by splint for ~4 more weeks after the cast comes off before unrestricted motion and load [Pillukat & van Schoonhoven 2009]. Weak / expert consensus.
  • Loading is added last, watching for the characteristic failure mode. Range and load are returned to normal after the rotation-limited window; the specific thing to watch is painful ulnar-stump instability and radioulnar convergence under axial/rotational load, which is the biomechanically demonstrated weak point of distal-ulna procedures [Sauerbier et al., J Hand Surg Br 2002; Douglas et al., J Hand Surg Am 2014; Barret et al., Orthop Traumatol Surg Res 2020]. Mechanistic (biomechanical) + consensus.
  • Finger, thumb, elbow and shoulder motion from day one is standard to prevent stiffness, as in any forearm/wrist immobilisation pathway. Consensus.

Recovery trajectory (expected, evidence-anchored)

Phase Window Restraint Hand use / therapy focus Strength / load Notes
I — Protected settling Week 0 to 2-3 Splint limiting forearm rotation (Muenster / above-elbow type) Active finger/thumb/shoulder ROM from day 1; elbow ROM as splint allows; first gentle pain-free rotation toward end of phase None through forearm Longer if concurrent TFCC repair or distal radius osteotomy (cast in supination ~4 wk)
II — Early forearm rotation (priority) Week 2-3 to 6 Unloaded; some protocols cap end-range rotation a few more weeks Active pronation/supination as the main focus, elbow tucked; add wrist ROM; finger/grip ROM; scar massage once healed No resisted/loaded rotation, no heavy grip Target restoration toward ~80° each direction; pain-free is the rule
III — Strengthening & return Week 6-8+ Restrictions lifted progressively Resisted grip first, then graded loaded rotation (hammer turns); task-specific loading Build load slowly; grip recovers toward ~85-90% contralateral Watch for ulnar-stump instability / radioulnar convergence under load

(Phase windows mirror the precautions and phase tables in the patient protocol; they are typical expert-consensus guides, not trial-derived deadlines, and lengthen with concurrent procedures.)

C. KEY CONTROVERSIES / EVIDENCE QUALITY

  1. HIT vs Darrach. The Darrach (complete distal ulna resection) is simpler but sacrifices the ulnar support structures and is more prone to painful proximal ulnar-stump instability and radioulnar convergence, especially in younger, higher-demand or post-traumatic patients. HIT preserves the TFCC/styloid/attachments to mitigate this — but biomechanical work shows HIT also converges under load, just to a different degree, so convergence is a spectrum, not a HIT-vs-Darrach binary [Sauerbier et al., J Hand Surg Br 2002; Douglas et al., J Hand Surg Am 2014]. Darrach remains reasonable in low-demand/elderly patients. *Moderate (biomechanical
  2. cohort).*
  3. HIT vs Sauvé-Kapandji. Sauvé-Kapandji fuses the DRUJ and creates a controlled proximal pseudarthrosis, preserving the ulnar head/buttress for the carpus; it is often favoured where ulnar translation of the carpus is a concern (e.g. rheumatoid), but it too can develop painful proximal-stump instability. Long-term Sauvé-Kapandji and modified-Sauvé-Kapandji series report durable function with that caveat [Reissner et al., J Hand Surg Eur 2021; Zimmermann et al., Arch Orthop Trauma Surg 2003]. Choice is patient- and pathology-specific, not evidence-mandated. Moderate.
  4. HIT vs ulnar-head (implant) replacement. Implant ulnar-head arthroplasty is an alternative — particularly for failed resection/instability salvage — restoring a load-bearing buttress, but it adds implant-specific complications. Long-term implant series report good outcomes; it is increasingly used to rescue a painful, unstable stump after resection-type procedures [Kakar et al., J Hand Surg Am 2010; Adams, Hand Clin 2010; Watts et al., Hand Clin 2010; Rekant, Hand Clin 2012]. Moderate.
  5. The rehab regimen itself is consensus, not trial-derived. No RCT compares immobilisation length, rotation timing or loading progression after HIT. The "brief protection → early rotation → graded load" structure is inferred from technique articles and the methods of level-IV outcome series. Exact phase timings are typical, not deadlines, and shift with concurrent procedures. Weak / expert consensus.
  6. Patient selection drives results. Inflammatory-arthritis patients report lower residual pain than post-traumatic patients in long-term follow-up; adjunct PIN neurectomy is associated with better pain scores. Both point to outcome being substantially a selection/technique matter, not a rehab one [HIT long-term cohort, Hand 2019]. Moderate (within level-IV data).

D. EVIDENCE STRENGTH FLAGS (summary)

  • STRONG (RCT / SR): none. There are no randomised trials of DRUJ HIT or of its rehabilitation.
  • MODERATE: the biomechanical basis of radioulnar convergence / ulnar-stump instability under load across distal-ulna procedures (cadaveric studies); the comparative trade-offs among HIT / Darrach / Sauvé-Kapandji / ulnar-head replacement (consistent cohort + mechanistic data).
  • LEVEL IV (cohort / case series — the outcome evidence): pain relief, grip recovery (~85-90% contralateral), pronation/supination gains (toward ~80° each), ~14% complication and ~8% reoperation rates, durability to ~8-9 years. Consistent but uncontrolled and surgeon-reported.
  • WEAK / EXPERT CONSENSUS (the rehab regimen): the specific brief-protection → early-rotation → graded-load programme, the Muenster/above-elbow splint choice, the ~2-3 week protected window, and all exact phase timings — derived from technique articles and the methods sections of level-IV series, lengthened by concurrent procedures. No comparative rehab evidence exists.

CITATIONS

RAG corpus (180,000+ Orthopaedic articles)

  • Glowacki KA. Hemiresection arthroplasty of the distal radioulnar joint. Hand Clin. 2005. DOI: 10.1016/j.hcl.2005.08.002
  • Sauerbier M, Fujita M, Hahn ME, et al. The dynamic radioulnar convergence of the Darrach procedure and the ulnar head hemiresection interposition arthroplasty: a biomechanical study. J Hand Surg Br. 2002. DOI: 10.1054/jhsb.2002.0763
  • Douglas KC, Parks BG, Tsai MA, et al. The biomechanical stability of salvage procedures for distal radioulnar joint arthritis. J Hand Surg Am. 2014. DOI: 10.1016/j.jhsa.2014.03.028
  • Barret H, Lazerges C, Chammas P, et al. Modification of matched distal ulnar resection for distal radio-ulnar joint arthropathy: analysis of distal instability and radio-ulnar convergence. Orthop Traumatol Surg Res. 2020. DOI: 10.1016/j.otsr.2020.07.008
  • Chidgey LK. The distal radioulnar joint: problems and solutions. J Am Acad Orthop Surg. 1995. DOI: 10.5435/00124635-199503000-00005
  • Murray PM. Current concepts in the treatment of rheumatoid arthritis of the distal radioulnar joint. Hand Clin. 2011. DOI: 10.1016/j.hcl.2010.10.002
  • Lee SK, Hausman MR. Management of the distal radioulnar joint in rheumatoid arthritis. Hand Clin. 2005. DOI: 10.1016/j.hcl.2005.08.009
  • Ozer K. Management of complications of distal radioulnar joint. Hand Clin. 2015. DOI: 10.1016/j.hcl.2014.12.003
  • Zimmerman RM, Jupiter JB. Instability of the distal radioulnar joint. J Hand Surg Eur Vol. 2014. DOI: 10.1177/1753193414527052
  • Rekant M. Distal ulna arthroplasties. Hand Clin. 2012. DOI: 10.1016/j.hcl.2012.08.016
  • Watts AC, Hayton MJ, Stanley JK. Salvage of failed distal radioulnar joint reconstruction. Hand Clin. 2010. DOI: 10.1016/j.hcl.2010.05.004
  • Kakar S, Swann R, Perry K, et al. Distal radioulnar joint implant arthroplasty: a long-term outcome analysis. J Hand Surg Am. 2010. DOI: 10.1016/j.jhsa.2010.05.010
  • Adams BD. Complications of wrist arthroplasty. Hand Clin. 2010. DOI: 10.1016/j.hcl.2010.01.006
  • Reissner L, Schweizer A, Unterfrauner I, et al. Long-term results of the Sauvé-Kapandji procedure. J Hand Surg Eur Vol. 2021. DOI: 10.1177/17531934211004459
  • Zimmermann R, Gschwentner M, Arora R, et al. Treatment of distal radioulnar joint disorders with a modified Sauvé-Kapandji procedure: long-term outcome with special attention to the DASH questionnaire. Arch Orthop Trauma Surg. 2003. DOI: 10.1007/s00402-003-0529-5
  • Nypaver C, Bozentka DJ. Distal radius fracture and the distal radioulnar joint. Hand Clin. 2021. DOI: 10.1016/j.hcl.2021.02.011
  • Pillukat T, van Schoonhoven J. Die Hemiresektions-Interpositionsarthroplastik des distalen Radioulnargelenks nach Bowers [The hemiresection-interposition arthroplasty of the distal radioulnar joint]. Oper Orthop Traumatol. 2009. DOI: 10.1007/s00064-009-1913-2

DRUJ hemiresection literature (URLs)

  • Bowers WH. Distal radioulnar joint arthroplasty: the hemiresection-interposition technique. J Hand Surg Am. 1985;10(2):169-178. https://www.jhandsurg.org/article/S0363-5023(85)80100-3/abstract (PMID: 3980927)
  • Hemiresection interposition arthroplasty of the distal radioulnar joint: a long-term outcome study. Hand (N Y). 2019. DOI: 10.1177/1558944719873430. https://pmc.ncbi.nlm.nih.gov/articles/PMC8461192/
  • Hemiresection capsuloretinacular interposition arthroplasty for distal radioulnar joint osteoarthritis. J Wrist Surg. 2023. DOI: 10.1055/s-0043-1771341. https://pmc.ncbi.nlm.nih.gov/articles/PMC11606672/
  • Mid- to long-term functional results after Bowers' hemiresection interposition arthroplasty of the distal radio-ulnar joint. PubMed. https://pubmed.ncbi.nlm.nih.gov/35238965/
  • Pillukat T, van Schoonhoven J. The hemiresection-interposition arthroplasty of the distal radioulnar joint (operative technique). Oper Orthop Traumatol. 2009. https://link.springer.com/article/10.1007/s00064-009-1913-2 (PMID: 20058126)
  • Ulnar head hemiresection with interposition and extensor reconstruction — surgical technique. OrthOracle. https://www.orthoracle.com/library/ulnar-head-hemiresection-with-interposition-and-extensor-reconstruction/

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