The palmar distal radioulnar ligament is the anterior component of the DRUJ capsular restraint system, running from the palmar aspect of the sigmoid notch to the fovea and palmar styloid of the ulnar head. It is the primary restraint to posterior DRUJ subluxation in supination.
Prevents posterior DRUJ subluxation in supination; allows controlled rotation while stabilising the joint; works in opposition to the dorsal DRUJ ligament.
The palmar DRUJ ligament is tensioned in forearm supination and becomes lax in pronation. DRUJ instability from TFCC peripheral tears involves disruption of this palmar ligament with or without the dorsal component. MRI arthrography identifies palmar DRUJ ligament tears at the foveal attachment. DRUJ reconstruction targets restoration of palmar and dorsal ligament tension.
Palmar radioulnar ligament disruption allowing posterior ulnar head subluxation in supination, producing DRUJ pain and instability managed by arthroscopic TFCC foveal repair or open DRUJ ligament reconstruction.
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