Adams-Berger Reconstruction for Chronic Distal Radioulnar Joint Instability: Prospective 12-Month Outcomes.

PURPOSE: To prospectively evaluate stability restoration and functional outcomes following Adams-Berger ligament reconstruction for chronic distal radioulnar joint instability at 12 months. METHODS: Thirty consecutive patients with symptomatic chronic distal radioulnar joint instability refractory to nonsurgical management underwent Adams-Berger ligament reconstruction using an autologous tendon graft. Patients with advanced arthritis, fixed bony deformity, or infection were excluded. Clinical evaluation included distal radioulnar joint stress testing, forearm pronation-supination range of motion, grip strength, Modified Mayo Wrist Score, Patient-Rated Wrist Evaluation, and Disabilities of the Arm, Shoulder and Hand score. Assessments were performed before surgery and at scheduled intervals through 12 months after surgery. RESULTS: At 12 months, substantial improvement in distal radioulnar joint stability was observed, with restoration of a firm end point and minimal residual translation in most patients. Grip strength increased compared with preoperative values. Forearm rotation was preserved within functional limits. Patient-reported outcome measures demonstrated marked reduction in pain and disability with corresponding improvement in overall upper-extremity function. Most patients achieved good to excellent clinical outcomes. No graft failures or revision procedures were recorded during the follow-up period. CONCLUSIONS: Adams-Berger ligament reconstruction demonstrated favorable short-term restoration of distal radioulnar joint stability with clinically meaningful improvement in strength and patient-reported outcomes at 12 months. Functional forearm rotation was preserved in this prospective cohort. TYPE OF STUDY/LEVEL OF EVIDENCE: Prospective Cohort Study II.