The dorsal radioulnar ligament is the dorsal deep component of the TFCC, originating from the dorsal margin of the sigmoid notch of the radius to the dorsal base of the ulnar styloid and the ulnar fovea. It stabilises the DRUJ against palmar displacement of the ulna during forearm pronation, when it becomes taut. Together with the palmar radioulnar ligament it provides circumferential DRUJ stability as the forearm rotates.
Stabilises the DRUJ against palmar ulnar displacement during forearm pronation, complementing the palmar radioulnar ligament which stabilises in supination.
The dorsal radioulnar ligament is taut in pronation and is the primary structure preventing palmar DRUJ instability. It is typically torn in combination with the palmar ligament in significant DRUJ injuries from falls on an extended pronated wrist. Isolated dorsal ligament tears are less common and produce more subtle instability. The two deep radioulnar ligaments together form the critical DRUJ stabilising complex; both must be assessed at wrist arthroscopy and repaired for complete DRUJ stability restoration.
Combined palmar and dorsal radioulnar ligament tears at the ulnar fovea produce complete DRUJ instability requiring repair of both components, performed either arthroscopically through the 6R wrist portal with suture passing at the fovea, or by open approach for better foveal visualisation and anchor placement.
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