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Post-traumatic degenerative changes can result from the involvement of the sigmoid notch in a distal radius fracture.
There is destruction of the articular surfaces of the ulnar head and sigmoid notch as well as loss of soft tissue stability.
Through the same graft harvested wound on volar aspect distal radius approached and a vertical tunnel made 3mm above and lateral to sigmoid notch.
The difference in radii of curvature of ulnar head and the sigmoid notch causes translation of ulna volarly in supination and dorsally in pronation.
1) Though slightly asymmetric to the ulnar head, the sigmoid notch has been shown to contribute approximately 20% of the stability of the DRUJ.
Motion at the DRUJ occurs through the ulna, seated within the sigmoid notch, and the gliding undersurface of the fibrocartilaginous disk of the triangular fibrocartilage complex (TFCC) (Fig.
Ulnar head prosthesis, in conjunction with sigmoid notch resurfacing offers an anatomic solution for the restoration of kinematics and stability for primary DRUJ treatment and salvage.