The dorsal radioulnar ligament proper is the deep component of the triangular fibrocartilage complex (TFCC), running from the dorsal edge of the sigmoid notch to the ulnar fovea and styloid base. It is stronger and more mechanically important than the palmar radioulnar ligament in restraining ulnar head dorsal subluxation during pronation.
Primary restraint to dorsal ulnar head subluxation during pronation; the stronger of the two deep TFCC radioulnar ligaments.
The dorsal radioulnar ligament proper is disrupted in TFCC foveal tears, which produce DRUJ instability and deep ulnar-sided wrist pain with loading in rotation. MRI arthrography with wrist in pronation demonstrates the foveal attachment. Arthroscopic repair of the foveal attachment restores DRUJ stability. The ligament attaches at the fovea — a subtle depression at the base of the ulnar styloid — which is the key surgical target.
Disruption of the dorsal radioulnar ligament proper at the ulnar fovea producing DRUJ instability with forearm rotation, diagnosed by the fovea sign (ulnocarpal tenderness) and MRI arthrography.
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