Stabilization of the distal ulna by transfer of the pronator quadratus origin.

Surgical and nonsurgical treatment of distal radioulnar joint instability has characteristically been unsatisfactory. This present paper presents a surgical method involving the removal and transfer of the origin of the pronator quadratus to a more dorsal position, which effectively gives a dynamic stabilization to the joint. Temporary internal immobilization is performed with a transverse Kirschner wire that is removed at four weeks, and graded physical therapy is started at that time.