Intermediate Cuneiform Resurfacing Arthroplasty for Combined Defects of the Sigmoid Notch and the Lunate Fossa of the Distal Radius.

Abstract

Posttraumatic comminution and bone loss at the sigmoid notch and the lunate fossa of the distal radius result in substantial impairment. Established salvage methods do not meet the physical demands of young patients. Replacement of the articular cartilage is challenging owing to the loss of 2 articular surfaces in different planes and the lack of a defined autogenous source to replace them simultaneously. The use of an intermediate cuneiform osteoarticular autograft to reconstruct the sigmoid notch and the lunate fossa is a new surgical technique that restores joint congruity and stability while allowing early active motion. In this study, we report a cadaver study detailing the anatomy, the surgical technique, and the functional and radiographic outcomes of our index case. Unlike alternative salvage techniques, restoration of the articular surface of the sigmoid notch and the lunate fossa allows early active and stable forearm and radiocarpal joint motion.