Replacement of the distal radio-ulnar joint with a  semi-constrained Scheker DRUJ prosthesis

Oper Orthop Traumatol. 2023 Aug 2. doi: 10.1007/s00064-023-00822-w. Online ahead of print.ABSTRACTOBJECTIVE: To describe the indications, operative technique, and long-term outcomes of patients treated with the Scheker (Aptis) distal radio-ulnar joint (DRUJ) prosthesis.INDICATIONS: The Scheker prosthesis is intended to replace the DRUJ in patients with rheumatoid, degenerative, or posttraumatic arthritis of the sigmoid notch and/or ulnar head, or in cases of gross instability of the DRUJ. Moreover, a Scheker prosthesis can be used to treat failed salvage procedures, such as the Sauvé-Kapandji procedure, ulnar head resection, and ulnar head arthroplasty.CONTRAINDICATIONS: Severe osteoporosis, active infection, immature skeleton, less than 14 cm of the proximal ulna remaining.SURGICAL TECHNIQUE: In supine position with the forearm in full pronation, an ulnar S‑shaped incision is made. The ulnar head is resected and the proximal part is brought to the palmar side to enable visualization of the sigmoid notch. Following preparation of the sigmoid notch and the proximal ulnar part of the radius, a radial plate is attached. When the position is verified with fluoroscopy, screw holes are drilled together with a separate hole for the radial peg. A metal stem is inserted in the ulnar shaft. A polymer ball is then slid on to a polished peg on top of the ulnar stem. This polymer ball is seated in the socket of the radial plate and fixed with a small metal cap. Radiographic images are ...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Source Type: research