Chronic instability of the distal radioulnar joint.

The ligament reconstruction technique described closely reconstructs the anatomic origin and insertion of the palmar and dorsal radioulnar ligaments. In a series of 14 patients, stability was completely restored in 12. Patients were able to return to their previous work, athletic activities, and avocations without limitations. Recovery of strength and motion was at least 85%. One patient with initial bidirectional instability and good early surgical correction developed recurrent volar instability. Another patient had persistent preoperative ulnocarpal instability and an insufficient volar rim of the sigmoid notch from a previous fracture, but the DRUJ was stabilized. Ligament reconstruction is effective for DRUJ instability but requires a competent sigmoid notch; however, it may not fully correct ulnocarpal instability.