Corrective osteotomy for malunion of distal diaphyseal/metaphyseal radius or ulna fracture affecting stability of the distal radioulnar joint

Four patients with dorsal dislocation of the distal radioulnar joint and ulnar styloid malunion had corrective osteotomy of the ulnar styloid. Dislocation of the distal radioulnar joint was reduced in three of four patients. Subluxation persisted in the remaining patient. Wrist function improved in all patients. These results support the contention that a displaced ulnar styloid fracture with distal radioulnar joint dislocation should be reduced and internally fixed. Corrective osteotomy is recommended for malunion of the ulnar styloid associated with dislocation of the distal radioulnar joint.

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Corrective Osteotomy for Volar Instability of the Distal Radioulnar Joint Associated with Radial Shaft Malunion

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhse.2007.04.018 ◽

2007 ◽

Vol 32 (5) ◽

pp. 573-577 ◽

Cited By ~ 7

Author(s):

T. ODA ◽

T. WADA ◽

S. ISOGAI ◽

K. IBA ◽

M. AOKI ◽

...

Keyword(s):

Bone Grafting ◽

Corrective Osteotomy ◽

Distal Radioulnar Joint ◽

Iliac Bone ◽

Wedge Osteotomy ◽

X Rays ◽

Opening Wedge ◽

Radioulnar Joint

Volar instability of the distal radioulnar joint is an uncommon wrist disorder. We report three cases of recurrent volar instability of the distal radioulnar joint secondary to fracture of the radial shaft. In all cases, X-rays showed a volar apex deformity of the radial shaft. Opening wedge osteotomy and iliac bone grafting was performed on the distal diaphysis of the radius instead of on the radial shaft, in order to adjust the distal radioulnar joint more easily. Pre-operative dislocations and painful clunks disappeared in all three patients. However, slight instability of the distal radioulnar joint remained in all cases. Osteoarthritis of the distal radioulnar joint was noted in one patient 31 months after the operation. All of the patients were satisfied with the results and did not desire further operations.

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Isolated Distal Ulna Fracture With Distal Radioulnar Joint Dislocation: A Novel Fracture Pattern

Hand ◽

10.1177/1558944719856116 ◽

2019 ◽

Vol 15 (4) ◽

pp. NP57-NP62

Author(s):

Matthew Ciminero ◽

Nick Yohe ◽

Garret Garofolo-Gonzalez ◽

Jack Choueka

Keyword(s):

Kirschner Wire ◽

Distal Radioulnar Joint ◽

Fracture Pattern ◽

Radius Fracture ◽

Distal Ulna ◽

Radioulnar Joint ◽

Ulna Fracture ◽

Kirschner Wire Fixation ◽

Treatment Plans ◽

Equivalent Strength

Background: Galeazzi fractures composed of a middle to distal third radius fracture with dislocation and/or instability at the distal radioulnar joint (DRUJ) have been well described for decades. However, the inverse scenario has seldom if ever been described in the literature. Methods: We explore the case of a 25-year-old active patient who experienced a traumatic distal ulna fracture with dislocation of the DRUJ without a distal radius fracture. Results: It was successfully treated with open reduction and Kirschner wire fixation. The patient regained equivalent strength and range of motion compared with the contralateral uninjured extremity. Conclusion: We feel this patient’s successful postoperative course can guide future treatment plans for orthopedic surgeons who encounter similar fractures.

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CORRECTIVE OSTEOTOMY FOR INTRA-ARTICULAR MALUNION OF THE SIGMOID NOTCH OF THE DISTAL PART OF THE RADIUS: A CASE REPORT

Hand Surgery ◽

10.1142/s0218810408003839 ◽

2008 ◽

Vol 13 (02) ◽

pp. 93-97 ◽

Cited By ~ 2

Author(s):

Chun-Ying Cheng ◽

Chung-Hsun Chang

Keyword(s):

Distal Radius Fracture ◽

Distal Radius ◽

Distal Part ◽

Corrective Osteotomy ◽

Distal Radioulnar Joint ◽

Radius Fracture ◽

Radioulnar Joint ◽

Sigmoid Notch ◽

Radiocarpal Joint ◽

Joint Incongruity

Joint incongruity at radiocarpal joint is a common complication of the distal radius fracture, and has received much attention and study. However, the problem and outcome of treatment of intra-articular incongruity at the sigmoid notch after distal radius fracture is rarely reported. We describe a patient with deformity of the distal radioulnar joint, and impairment of supination after distal radius fracture. The evaluation of the distal radioulnar joint revealed the absence of degenerative arthritis and malunion of the sigmoid notch of the distal radius with a prominent volar lip limiting supination. We present a method of corrective osteotomy for the malunited sigmoid notch of the distal radius, to correct the incongruity of the distal radioulnar joint and restore supination.

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REMODELING OF DISTAL ULNA AFTER EXCISION ARTHROPLASTY FOR ACUTE COMMINUTED DISTAL ULNAR FRACTURE: A CASE REPORT

Hand Surgery ◽

10.1142/s0218810411005631 ◽

2011 ◽

Vol 16 (03) ◽

pp. 327-333

Author(s):

Chun-Ying Cheng

Keyword(s):

Case Report ◽

Distal Radioulnar Joint ◽

Bone Adaptation ◽

Distal Ulna ◽

Radioulnar Joint ◽

Ulna Fracture ◽

Ulnar Head ◽

Ulnar Fracture ◽

The Stability ◽

Excision Arthroplasty

Bone adaptation after excision arthroplasty of distal radioulnar joint in an acute traumatic distal ulna fracture has never been reported. A case of irreparable and comminuted distal ulnar head fracture was managed by excising the ulna head and repairing the fovea (deep ligament) attachments of distal radioulnar ligaments, and then an unexpected remodeling of the distal ulna with the shape of pole and seat was noted. The anatomy of deep fibers of distal radioulnar ligament is important not only in biomechanics about the stability of distal radioulnar joint but it is also possible in the morphology about the shape of the distal radioulnar joint.

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Corrective osteotomy in forearm fracture malunion improves functional outcome in adults

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193410380585 ◽

2010 ◽

Vol 36 (2) ◽

pp. 102-106 ◽

Cited By ~ 12

Author(s):

D. S. Y. Chia ◽

Y. J. Lim ◽

W. Y. C. Chew

Keyword(s):

Functional Impairment ◽

Joint Instability ◽

Forearm Fracture ◽

Corrective Osteotomy ◽

Distal Radioulnar Joint ◽

Forearm Fractures ◽

Forearm Rotation ◽

Radioulnar Joint ◽

Initial Injury

Malunions of forearm fractures in adults can present with limitation of forearm rotation, or as distal radioulnar joint instability with functional impairment. This contrasts with paediatric patients in whom malunions of similar severities are often better tolerated. We did a retrospective review of six adult patients after corrective forearm osteotomy for symptomatic malunited forearm shaft fractures. The corrective operations were done between 7 and 168 months after initial injury, using oblique or wedge osteotomies. Median follow-up was 22.5 months. The patients recovered well, with statistically significant improvement in forearm rotation and Disabilities of the Arm, Shoulder, and Hand (DASH) scores. No significant complications occurred.

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Biomechanical Study of Distal Radioulnar Joint (DRUJ) Ballottement Test

Journal of Wrist Surgery ◽

10.1055/s-0035-1545640 ◽

2015 ◽

Vol 04 (S 01) ◽

Author(s):

Shohei Omokawa ◽

Hisao Moritomo

Keyword(s):

Distal Radioulnar Joint ◽

Biomechanical Study ◽

Radioulnar Joint

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Range of Motion after the Sauvé–Kapandji and Darrach Procedures without Extensor Tendon Rupture

Journal of Wrist Surgery ◽

10.1055/s-0040-1721452 ◽

2020 ◽

Author(s):

Tomoyuki Kato ◽

Taku Suzuki ◽

Makoto Kameyama ◽

Masato Okazaki ◽

Yasushi Morisawa ◽

...

Keyword(s):

Range Of Motion ◽

Tendon Rupture ◽

Extensor Tendon ◽

Distal Radioulnar Joint ◽

Wrist Flexion ◽

Level Of Evidence ◽

Radioulnar Joint ◽

The Mean ◽

Therapeutic Study ◽

Loss Of Motion

Abstract Background Previous study demonstrated that distal radioulnar joint (DRUJ) plays a biomechanical role in extension and flexion of the wrist and suggested that fixation of the DRUJ could lead to loss of motion of the wrist. Little is known about the pre- and postoperative range of motion (ROM) after the Sauvé–Kapandji (S-K) and Darrach procedures without tendon rupture. To understand the accurate ROM of the wrist after the S-K and Darrach procedures, enrollment of patients without subcutaneous extensor tendon rupture is needed. Purpose This study aimed to investigate the pre- and postoperative ROM after the S-K and Darrach procedures without subcutaneous extensor tendon rupture in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Methods This retrospective study included 36 patients who underwent the S-K procedure and 10 patients who underwent the Darrach procedure for distal radioulnar joint disorders without extensor tendon rupture. Pre- and postoperative ROMs after the S-K and Darrach procedures were assessed 1 year after the surgery. Results In the S-K procedure, the mean postoperative ROM of the wrist flexion (40 degrees) was significantly lower than the mean preoperative ROM (49 degrees). In wrist extension, there were no significant differences between the mean preoperative ROM (51 degrees) and postoperative ROM (51 degrees). In the Darrach procedure, the mean postoperative ROM of the wrist flexion and extension increased compared with the mean preoperative ROM; however, there were no significant differences. Conclusion In the S-K procedure, preoperative ROM of the wrist flexion decreased postoperatively. This study provides information about the accurate ROM after the S-K and Darrach procedures. Level of Evidence This is a Level IV, therapeutic study.

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