STABILISATION OF THE DISTAL ULNA USING EXTENSOR CARPI ULNARIS TENODESIS AFTER HEMIRESECTION — INTERPOSITION TECHNIQUE

A new stabilisation technique has been developed by the authors for the prevention of instability of the distal ulna after performance of Bower's hemiresection-interposition technique in rheumatoid patients, is described. This technique consists of the transfer of the extensor carpi ulnaris over the dorsal aspect of the distal ulna and suturing it to the soft tissue over the distal ulna. Operation was performed in 16 rheumatoid patients with 20 wrist joints. The results were evaluated in terms of both subjective (pain during rotation, pain on compression of the ulna) and objective evaluations (wrist/forearm range of motion, grip strength). After the operation, the pain almost disappeared in all but two cases which had insufficient bone excision. Wrist extension/flexion and pronation/supination improved after operation. Average grip strengths also improved. None of the cases showed instability of the distal ulna after the operation. Wrist extension strength did not decrease after operation in spite of tenodesis of the extensor carpi ulnaris. This technique is simple and useful for prevention of instability of the distal ulna after hemiresection-interposition technique has been carried out in rheumatoid patients.