The "Four-Leaf Clover" Treatment Algorithm: A Practical Approach to Manage Disorders of the Distal Radioulnar Joint

Sanjeev Kakar, Marc Garcia-Elias

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Most symptomatic distal radioulnar joint (DRUJ) conditions result from derangements to several structures that may include the length, shape, and/or orientation of the articulating surfaces; the cartilage of the DRUJ and/or ulnocarpal joint; the DRUJ and/or ulnocarpal joint ligaments; and the extensor carpi ulnaris and/or pronator quadratus muscle. Once a complete diagnosis is made, often only one of these components is addressed, which results in suboptimal clinical outcomes. In this article, we present a treatment algorithm (the Four-Leaf Clover algorithm) to guide treatment of DRUJ pathology. The Four-Leaf Clover principle is a guiding algorithm, not a document forcing the surgeon to adopt one particular treatment. Its purpose is to provide treating physicians with a checklist that helps ensure that they do not miss any of the different components that need to be addressed for a complete treatment. Using the treatment algorithm, we should achieve satisfactory resolution of patients' symptoms after addressing the particular components in a stepwise approach.

Original languageEnglish (US)
JournalJournal of Hand Surgery
DOIs
StateAccepted/In press - Nov 16 2015

Keywords

  • Distal radioulnar joint
  • Distal radioulnar joint pathology
  • Treatment

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

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