Abstract
Background Injury to the distal radioulnar joint (DRUJ) causes swelling and ulnar-sided wrist
pain. The Adams procedure stabilizes the DRUJ and shows promising short-term results.
Purpose We studied the long-term functional outcome in patients who underwent the Adams procedure.
We also tested the null hypothesis that there would be no difference in range of motion
(ROM) and grip strength between the operated wrist compared to the unaffected side.
Patients and Methods We identified 74 consecutive patients that were operated from March 2005 to February
2014. Twenty-three patients responded to our invitation and underwent clinical follow-up.
Three patients had a re-do of the Adams procedure after presenting with postoperative
DRUJ instability, one was excluded due to additional wrist surgery not related to
the initial procedure. Wrist functionality in the remaining 22 patients was examined
by measuring ROM in all planes and grip strength of the operated and non-operated
hand. Functional outcome was measured by asking patients to complete the Disabilities
of the Arm, Shoulder, and Hand (DASH) outcome measure and the Patient-Rated Wrist
and Hand Evaluation (PRWHE).
Results After a mean follow-up time of 5.0 years (standard deviation [SD] 2.0), we found
that supination, pronation, and grip strength were significantly decreased in the
operated wrist. Postoperative DASH and PRWHE-scores averaged 13.1 (SD 18.6) and 20.3
(SD 15.1), respectively.
Conclusion The Adams procedure affects, but largely restores pronation and supination, and clinical
examination, DASH, and PRWHE scores indicate that the Adams procedure leaves patients
with upper extremity functionality comparable to a healthy population.
Level of Evidence Level IV.
Keywords
function - long term - Adams procedure - DRUJ - reconstruction - DASH - PRWHE
