Outcomes of the Adams–Berger Ligament Reconstruction for the Distal Radioulnar Joint Instability in 95 Consecutive Cases

Abstract

Objective The objective of this article is to evaluate the outcomes and complication rate for Adams–Berger anatomic reconstruction of the distal radioulnar joint (DRUJ), in addition, to determine the role of sigmoid notch anatomy on failure.

Methods We conducted a retrospective chart review to evaluate adult patients that had undergone reconstruction of the DRUJ for instability with the Adams–Berger procedure between 1998 and 2015 within our institution with > 24 months follow-up. Charts were reviewed for patient demographics, mechanism of injury, outcome, and complications.

Results Ninety-five wrists in 93 patients were included. Mean age at surgery was 37.3 years with 65.2 months follow-up. At the last follow-up, 90.8% had a stable DRUJ, 5.3% did not, and 3.4% had some laxity. Postoperatively, 75.9% described either no pain or mild pain. Grip strength increased while pronosupination decreased. Procedure success was 86.3%, as 12 patients underwent revision at 13.3 months postoperatively. Reconstructive failure was more common in females when an interference screw was utilized for tendon fixation. Age, timing of surgery, type of graft, sigmoid notch anatomy, and previous surgery did not affect revision or failure rate.

Conclusion Our findings demonstrate that Adams–Berger reconstruction of the DRUJ provides reliable long-term results with an overall success of 86% at > 5 years follow-up.

Level of evidence/Type of study This is a Level IV, therapeutic study.

Keywords

Adams–Berger procedure - DRUJ instability - distal radial ulnar joint - DRUJ reconstruction - ulnar-sided wrist pain

Note

Institutional ethics was approved for the use of personal health data. All work was performed at the Mayo Clinic in Rochester, MN.

^* These authors are co-authors as they contributed equally to this article.

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