Adams-Berger Reconstruction for Chronic Distal Radioulnar Joint Instability: Prospective 12-Month Outcomes.

Abstract

To prospectively evaluate stability restoration and functional outcomes following Adams-Berger ligament reconstruction for chronic distal radioulnar joint instability at 12 months. Thirty consecutive patients with symptomatic chronic distal radioulnar joint instability refractory to nonsurgical management underwent Adams-Berger ligament reconstruction using an autologous tendon graft. Patients with advanced arthritis, fixed bony deformity, or infection were excluded. Clinical evaluation included distal radioulnar joint stress testing, forearm pronation-supination range of motion, grip strength, Modified Mayo Wrist Score, Patient-Rated Wrist Evaluation, and Disabilities of the Arm, Shoulder and Hand score. Assessments were performed before surgery and at scheduled intervals through 12 months after surgery. At 12 months, substantial improvement in distal radioulnar joint stability was observed, with restoration of a firm end point and minimal residual translation in most patients. Grip strength increased compared with preoperative values. Forearm rotation was preserved within functional limits. Patient-reported outcome measures demonstrated marked reduction in pain and disability with corresponding improvement in overall upper-extremity function. Most patients achieved good to excellent clinical outcomes. No graft failures or revision procedures were recorded during the follow-up period. Adams-Berger ligament reconstruction demonstrated favorable short-term restoration of distal radioulnar joint stability with clinically meaningful improvement in strength and patient-reported outcomes at 12 months. Functional forearm rotation was preserved in this prospective cohort. Prospective Cohort Study II.