Hemiresection arthroplasty of the distal radioulnar joint.

One of the critical requirements for this procedure to succeed is a functional TFCC structure. In rheumatoid arthritis or traumatic disruption of the DRUJ, the TFCC is unstable. If the TFCC can be reconstructed and DRUJ arthritis exists, this is the situation in which the hemiresection procedure excels. In the face of a normal DRUJ without arthritis, an ulnar shortening with a repair of the TFCC, if necessary, is the more appropriate procedure. The other caveat for this procedure to succeed is a careful preoperative plan to make sure stylocarpal impingement does not occur. The procedure does not restore stability in the unstable painful radioulnar joint; it simply substitutes a less painful instability. When correctly planned and performed the hemiresection interposition technique can be a good procedure in the arsenal of treatment for the DRUJ.