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[Bowers hemi-resection-interposition arthroplasty for treatment of post-traumatic arthrosis of the distal radio-ulnar joint after distal radius fractures].

UNLABELLED
Arthrosis of the distal radioulnar joint (DRUJ) is a common problem following fractures of the distal radius. The treatment options include the hemiresection-interposition technique (Bowers procedure) or Kapandji-Sauvé procedure. In a retrospective study, we assessed the results of the Bowers procedure.


MATERIAL AND METHODS
From 1992 to 1997, 24 patients were treated by the hemiresection-interposition technique (Bowers procedure) for arthrosis of the DRUJ following fracture of the distal radius. The average follow-up time was 30.5 (9 to 55) months.


RESULTS
The average preoperative pronation was 67 degrees, the supination 45 degrees. Postoperatively, we found a pronation of 80 degrees and a supination of 62 degrees. Grip-strength compared to the opposite site could be improved from 38 to 57% postoperatively. Pain was reduced markedly in 78% of the patients. However, ten patients developed a postoperative instability of the distal ulna. In only two patients did painful instability necessitate revision procedures.


CONCLUSION
The hemiresection-interposition technique is a salvage procedure for the destroyed DRUJ, leading to good clinical results in most patients. Painful instability of the distal ulna and remaining functional deficits can be the reasons for failure. Therefore, adequate primary reduction of fractures of the distal radius or secondary reconstruction of the anatomy is necessary to prevent secondary arthrosis of the DRUJ.