Ligament reconstruction with modified suture anchor fixation technique for chronic distal radioulnar joint instability: A case report and literature review

Introduction: The chronic instability of the DRUJ should be appropriately treated. Ligament reconstruction in the original technique needs an adequate length of the graft, which needs to be modified in such a case.

Case presentation: A 27-year-old male presented with right wrist pain accompanied by limited movement that has been felt for the last two months. There was an obvious deformity with tenderness. Palpation revealed a positive ballottement and piano-key sign test. An X-ray examination revealed a union fracture one-third distally on the right radius bone with dorsal dislocation of the right distal radioulnar joint. The result of an MRI confirmed a triangular fibrocartilage complex tear. The patient was diagnosed with chronic DRUJ instability.

Discussion: We performed a chronic DRUJ reconstruction using the harvesting palmaris longus tendon. However, the length of the graft is too short. Further, we performed a modified technique with suture anchor fixation for this patient. This technique could be a helpful alternative if the length of the graft is insufficient. As a result, there was an improvement in the DASH score and EQ5D questionnaires.

Conclusion: Chronic DRUJ instability could be treated by ligament reconstruction with modified suture anchors fixation in the inadequate length of the graft situation.