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Sussex CONDITION Distal Radio Ulnar Surgery

CONDITION

The DRUJ is the joint between the end of the What is and , just before the wrist. This joint is where rotation occurs (twisting movements of the hand and wrist). Distal Radio Ulnar There is also a pivot between the radius and ulna bones near the and the two work Joint Arthritis? together to allow forearm rotation.

Normal Wrist Xray this joint, especially the tendons What treatments are to the little . If the swelling available for DRUJ arthritis? in the joint is very marked the extensor tendons can Most patients with this condition do be involved and even tear apart not need surgery but manage with Distal Radio and stop working. This is a very various combinations of painkillers, Ulnar Joint urgent situation to deal with as splints and activity modification. once one tendon has gone the Steroid injections might be offered next ones along are at increased to try and reduce local End of radius End of ulna risk of tearing. inflammation within the joint. In later cases the joint may If the pain is more severe or the become unstable resulting in tendons are at risk surgery might ‘Scalloping’ of an arthritic DRUJ – a sign of danger clunking and clicking when the be recommended. This might for the extensor tendons forearm is rotated. need to be arranged urgently if the tendons are showing signs of wear or have already torn. The surgery Arthritis at the How is the diagnosis of will need to address the base of the DRUJ arthritis made? underlying cause of the problem is also present Worn out The story from you, the patient, (dealing with the arthritic joint) as end of ulna – and a careful examination usually well as cleaning up (or repairing) odd shape suggest a problem on the ulnar the tendons. Various options are ‘Scalloping’ of side of the wrist. available for the joint including distal radius – An Xray of the wrist will often removing all or part of the joint or very obvious in show characteristic changes of replacing the joint. A careful soft this patient inflammatory or osteoarthritis tissue repair is very important in some of which are predictors of all these operations. Your surgeon problems with the extensor will advise you regarding this. What is Distal Radio Ulnar What symptoms do you tendons. Joint (DRUJ) arthritis? get with DRUJ arthritis? A Magnetic Resonance Imaging What are the results of Sometimes the DRUJ wears out and Some people seem to tolerate (MRI) scan or Computerised treatment for DRUJ arthritis? becomes arthritis. This is common damage to the DRUJ well but Tomography (CT) scan is Once the joint has become with inflammatory arthritis patterns others develop pain in the joint. sometimes ordered to give more arthritic or the tendons have worn (such as ) but This is often worse with loading information about the soft tissues through it is not possible to can also occur with simple ‘wear (heavier activity) and also with and joint alignment. restore completely normal and tear’ as in osteoarthritis. It is activities involving rotating the function of the tendons and . not clear why this joint should wear forearm (turning a key or Treatment is aimed at relieving out in some people rather than screwdriver for instance). symptoms as much as possible others but it probably relates to the Swelling around the ulnar (little and improving each patient’s exact shape of the joint, how well finger) side of the wrist also occur. function. Caught early tendon aligned the radius and ulna are The extensor tendons (which damage can be minimised and when they move against each other straighten up the ) are good movement of the digits and any injuries that the joint particularly close to the back of re-gained after surgery, with the sustains over time. help of the hand therapists.

www.sussexhandsurgery.co.uk These notes are intended as a guide and some of the © Sussex details may vary depending on your individual January 2018 circumstance and at the discretion of your surgeon.