The actual management of distal radio-ulnar joint instability

Pain on the ulnar side of the wrist has numerous causes ranging from soft tissue to bony problems. One of the causes is instability of the distal radioulnar joint. The spectrum of symptoms is wide and diagnostic tools limited. As instability is a clinical problem grading is subjective. Attempts have been made to design a grading system on static ct scans but none are really useful. If left untreated, signs and symptoms will worsen with time, limiting treatment option. Treatment can be either soft tissue repair, sigmoid notch osteotomy, tenodesis, ligament reconstruction and prosthetic implantation. This paper discusses pertinent anatomy, clinical presentation, diagnostic tools and finally treatment options.