Partial or complete prosthetic replacement arthroplasty of the distal radioulnar joint
First Claim
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1. A method of repairing a distal radioulnar joint formed by a radius and an ulna, the method comprising:
- cutting through a shaft region of the ulna to form a proximal ulnar fragment and a distal ulnar fragment;
pivoting the distal ulnar fragment away from the proximal ulnar fragment to a pivoted configuration;
removing bone from a sigmoid fossa region of the radius, from a generally laterally facing region of the distal ulnar head, or from both, while the distal ulnar fragment is in the pivoted configuration;
installing a radial prosthesis, an ulnar prosthesis, or both, in place of bone that has been removed, to replace at least one surface region of the distal radioulnar joint; and
fixing the proximal and distal ulnar fragments relative to each other.
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Abstract
System, including methods, apparatus, and kits, for replacement of at least one surface region of a distal radioulnar joint using at least one prosthesis. In some embodiments, the system may provide restoration of normal, unconstrained biomechanics of the joint, which may preserve rotation and translation and ensure durability of the joint.
39 Citations
31 Claims
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1. A method of repairing a distal radioulnar joint formed by a radius and an ulna, the method comprising:
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cutting through a shaft region of the ulna to form a proximal ulnar fragment and a distal ulnar fragment; pivoting the distal ulnar fragment away from the proximal ulnar fragment to a pivoted configuration; removing bone from a sigmoid fossa region of the radius, from a generally laterally facing region of the distal ulnar head, or from both, while the distal ulnar fragment is in the pivoted configuration; installing a radial prosthesis, an ulnar prosthesis, or both, in place of bone that has been removed, to replace at least one surface region of the distal radioulnar joint; and fixing the proximal and distal ulnar fragments relative to each other. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A method of repairing a distal radioulnar joint formed by a radius and an ulna, the method comprising:
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cutting through a shaft region of the ulna to form a proximal ulnar fragment and a distal ulnar fragment; pivoting the distal ulnar fragment away from the proximal ulnar fragment to a pivoted configuration; forming a cavity in a sigmoid fossa region of the radius while the distal ulnar fragment is in the pivoted configuration; attaching a radial prosthesis to the radius with the radial prosthesis at least partially in the cavity, to replace a radial surface region of the distal radioulnar joint; and securing a bone plate to the ulna to fix the proximal and distal ulnar fragments relative to each other. - View Dependent Claims (16)
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17. A method of repairing a distal radioulnar joint formed by a radius and an ulna, the method comprising:
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cutting through a shaft region of the ulna to form a proximal ulnar fragment and a distal ulnar fragment; moving the distal ulnar fragment away from the proximal ulnar fragment to a spaced configuration; removing bone from a sigmoid fossa region of the radius, from a generally laterally facing region of the distal ulnar head, or from both, while the distal ulnar fragment is in the spaced configuration; installing a radial prosthesis, an ulnar prosthesis, or both, in place of bone that has been removed, to replace at least one surface region of the distal radioulnar joint; fixing the proximal and distal ulnar fragments relative to each other; and resecting a lateral portion of the distal ulnar head before the step of removing bone, to form the generally laterally facing region of the distal ulnar head. - View Dependent Claims (18, 19, 20, 21, 22, 23)
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24. A method of repairing a distal radioulnar joint formed by a radius and an ulna, the method comprising:
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cutting through a shaft region of the ulna to form a proximal ulnar fragment and a distal ulnar fragment; moving the distal ulnar fragment away from the proximal ulnar fragment to a spaced configuration; removing bone from a sigmoid fossa region of the radius, from a generally laterally facing region of the distal ulnar head, or from both, while the distal ulnar fragment is in the spaced configuration; installing a radial prosthesis, an ulnar prosthesis, or both, in place of bone that has been removed, to replace at least one surface region of the distal radioulnar joint; and fixing the proximal and distal ulnar fragments relative to each other, wherein attachment of the triangular fibrocartilage complex to the radius and the ulna is not disturbed by any of the steps of cutting, moving, removing, installing, or fixing. - View Dependent Claims (25, 26)
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27. A method of repairing a distal radioulnar joint formed by a radius and an ulna, the method comprising:
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cutting through a shaft region of the ulna to form a proximal ulnar fragment and a distal ulnar fragment; moving the distal ulnar fragment away from the proximal ulnar fragment to a spaced configuration; removing bone from a sigmoid fossa region of the radius, from a generally laterally facing region of the distal ulnar head, or from both, while the distal ulnar fragment is in the spaced configuration; installing a radial prosthesis, an ulnar prosthesis, or both, in place of bone that has been removed, to replace at least one surface region of the distal radioulnar joint; fixing the proximal and distal ulnar fragments relative to each other; and placing an elongate guide member into the radius and ulna such that the guide member defines a linear datum extending through the joint, wherein the step of removing bone includes a step of positioning a bone-removal tool based on the linear datum. - View Dependent Claims (28, 29)
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30. A method of repairing a distal radioulnar joint formed by a radius and an ulna, the method comprising:
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cutting through a shaft region of the ulna to form a proximal ulnar fragment and a distal ulnar fragment; moving the distal ulnar fragment away from the proximal ulnar fragment to a spaced configuration; removing bone from a sigmoid fossa region of the radius, from a generally laterally facing region of the distal ulnar head, or from both, while the distal ulnar fragment is in the spaced configuration; installing a radial prosthesis, an ulnar prosthesis, or both, in place of bone that has been removed, to replace at least one surface region of the distal radioulnar joint; and fixing the proximal and distal ulnar fragments relative to each other, wherein the ulnar prosthesis has a head connected to a stem, and wherein the step of installing disposes the stem in a bore formed in the ulna, further comprising a step of forming the bore in the ulna with the bore oriented transversely or orthogonally to a longitudinal axis defined by the ulna. - View Dependent Claims (31)
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Specification