Extensor Tendon Rupture After Distal Radioulnar Joint Surgery: A Case Series

Symptomatic arthritis of the distal radioulnar joint (DRUJ) is often treated nonoperatively but with persistent symptoms may be treated surgically with partial or complete distal ulna resection. In many of these cases, ulna resection in combination with tendon reconstruction can successfully restore hand function. We identified three patients who underwent the Darrach procedure to treat DRUJ arthritis that developed attritional ruptures due to sharp prominent bone edges or dorsal capsule disruption. In addition to our recent three patients, an additional three isolated case reports, and two cases in a 29-patient series reported post-operative extensor tendon rupture as a complication after a Darrach procedure more than 30 years ago. While extensor tendon rupture is rarely reported in recent literature as a complication of distal ulna excision, surgeons may be able to minimize the risk of this complication intra-operatively by ensuring the resected distal ulnar stump is smooth, free of bony prominences, any capsular deficiencies are reconstructed, and that extensor tendons are able to glide freely.