18 Reconstruction of Distal Radioulnar Ligaments

• Approach the DRUJ through fifth extensor compartment, leaving its distal portion intact.
  
• Reflect the retinaculum ulnarly but do not open the sixth extensor compartment (Fig. 18-1).
  
• Create an L-shaped capsulotomy with one limb just proximal to the dorsal radioulnar ligament and the other along the edge of the sigmoid notch (Fig. 18-2).

Pitfall

Avoid cutting the triangular fibrocartilage complex (TFCC) remnant by gradually incising the capsule from proximal to distal along the sigmoid notch until the dorsal radioulnar ligament is reached.

Figure 18-1

• Using a cannulated drill system, create a dorsal to volar tunnel through the distal ulnar corner of the radius (Fig. 18-3).

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