Operative Techniques: Hand and Wrist Surgery

Forearm fracture-dislocations (Galeazzi and Monteggia)

Indications Radius and ulna fracture-dislocations require operative treatment in the adult population. The forearm unit consists of the ulna and radius, which are held together proximally at the proximal radioulnar joint (PRUJ), at the interosseous membrane (IOM) along the shaft,…

Corrective osteotomy of radius malunion

Indications Pain or functional impairment in the setting of radiocarpal or distal radioulnar joint (DRUJ) malalignment There are no fixed radiographic criteria for correction, although symptoms often present with radial inclination of less than 10 degrees, volar or dorsal tilt…

Operative treatment of distal radius fractures

Indications Operative management is indicated for distal radius fractures that have a dorsal tilt greater than 10 degrees, radial inclination angle of less than 15 degrees, radial shortening greater than 5 mm, positive ulnar variance greater than 3 mm, and/or…

Distal radioulnar joint reconstruction using palmaris longus graft

Indications Indications for this procedure include: Chronic, symptomatic distal radioulnar joint (DRUJ) instability that is generally associated with irreparable triangular fibrocartilage complex (TFCC) injury No evidence of distal radioulnar joint arthritis. No evidence of a malunited distal radius fracture with…

Ulnar shortening osteotomy for ulnar impaction syndrome

Indications Indications for the procedure include: Inherited or acquired ulnocarpal abutment (ulnar impaction syndrome) Posttraumatic incongruency of the distal radioulnar joint (DRUJ) Loss of radial height associated with distal radius fracture malunion Madelung deformity or premature physeal closure of the…