{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T02:05:27Z","timestamp":1780365927827,"version":"3.54.1"},"reference-count":42,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hand Surg Eur Vol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>Distal radioulnar joint (DRUJ) balance is essential for forearm rotation, load transmission, and overall wrist function. Traumatic injuries \u2013 including foveal triangular fibrocartilage complex (TFCC) tears, distal radius malunions and disruption of the distal oblique bundle \u2013 represent the most common causes of symptomatic DRUJ instability. Accurate differentiation between physiological laxity and clinically relevant instability remains challenging owing to limited reliability of physical examination and the subtle nature of soft-tissue pathology. Comprehensive assessment requires detailed anatomical understanding, structured clinical evaluation, multimodal imaging and, when indicated, diagnostic arthroscopy. Advances in minimally invasive surgical techniques have transformed the management of DRUJ instability. Arthroscopic interventions allow precise identification and treatment of TFCC lesions, enabling foveal repairs, capsular reinforcement, and tendon-graft reconstructions while minimizing soft-tissue disruption. Open yet minimally invasive procedures \u2013 including suture-button suspension constructs and distal oblique bundle reinforcement \u2013 offer additional options for restoring stability, particularly in chronic or complex cases. Treatment selection depends on underlying pathoanatomy, patient age, severity of instability and associated osseous deformities such as distal radius malunion or ulnar-positive variance. Postoperative recovery requires careful monitoring of stability, range of motion and functional progression, with growing evidence supporting shorter immobilization and early supervised mobilization in stable repairs. A stepwise algorithm integrating anatomical, clinical, radiographic and arthroscopic findings can guide decision-making and optimize outcomes. As diagnostic imaging and arthroscopic techniques continue to evolve, minimally invasive approaches will play an increasingly central role in restoring DRUJ balance, improving function and preventing long-term degenerative change.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Level Evidence:<\/jats:bold>\n                    V\n                  <\/jats:p>","DOI":"10.1177\/17531934261417561","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T06:10:28Z","timestamp":1776233428000},"page":"793-802","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Restoring balance in the distal radioulnar joint: advancements in minimally invasive surgical approaches"],"prefix":"10.1177","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8650-7061","authenticated-orcid":false,"given":"Gerald A","family":"Kraan","sequence":"first","affiliation":[{"name":"Reinier de Graaf Hospital, Department of Orthopedics and Traumatology, the Netherlands"},{"name":"Reinier HAGA Orthopedic Center, Department of Orthopedics, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Arora","sequence":"additional","affiliation":[{"name":"University Hospital Innsbruck, Department of Orthopedics and Traumatology, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pak Cheong","family":"Ho","sequence":"additional","affiliation":[{"name":"Prince of Wales Hospital, Chinese University of Hong Kong, Department of Orthopaedic and Traumatology, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels WL","family":"Schep","sequence":"additional","affiliation":[{"name":"Maasstad Hospital, Trauma Surgery Department, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1742271X15587599"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753193409100120"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2021.03.005"},{"key":"e_1_3_2_5_1","article-title":"Treatment recommendations for suspected scapholunate ligament pathology","volume":"11","author":"Bakker D","year":"2021","unstructured":"Bakker D, Kortlever JTP, Kraan GA, Mathijssen N, Colaris JW, Ring D; Science of Variation Group. 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