scholarly journals Nonsurgical Treatment for Acute Posttraumatic Distal Radioulnar Joint Instability: A Case Series

2020 ◽  
Vol 2 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Andrew J. Bachinskas ◽  
Elizabeth A. Helsper ◽  
Harry A. Morris ◽  
Bernard F. Hearon
Keyword(s):  
Joint Instability ◽  
Case Series ◽  
Distal Radioulnar Joint ◽  
Nonsurgical Treatment ◽  
Radioulnar Joint

Patients with triangular fibrocartilage complex injuries and distal radioulnar joint instability have reduced rotational torque in the forearm

2016 ◽  
Vol 41 (7) ◽  
pp. 732-738 ◽  
Author(s):  
J. K. Andersson ◽  
P. Axelsson ◽  
J. Strömberg ◽  
J. Karlsson ◽  
J. Fridén
Keyword(s):  
Joint Instability ◽  
Clinical Signs ◽  
Case Series ◽  
Distal Radioulnar Joint ◽  
Triangular Fibrocartilage Complex ◽  
Wrist Arthroscopy ◽  
Level Of Evidence ◽  
Independent Observer ◽  
Radioulnar Joint ◽  
Triangular Fibrocartilage

A total of 20 patients scheduled for wrist arthroscopy, all with clinical signs of rupture to the triangular fibrocartilage complex and distal radioulnar joint instability, were tested pre-operatively by an independent observer for strength of forearm rotation. During surgery, the intra-articular pathology was documented by photography and also subsequently individually analysed by another independent hand surgeon. Arthroscopy revealed a type 1-B injury to the triangular fibrocartilage complex in 18 of 20 patients. Inter-rater reliability between the operating surgeon and the independent reviewer showed absolute agreement in all but one patient (95%) in terms of the injury to the triangular fibrocartilage complex and its classification. The average pre-operative torque strength was 71% of the strength of the non-injured contralateral side in pronation and supination. Distal radioulnar joint instability with an arthroscopically verified injury to the triangular fibrocartilage complex is associated with a significant loss of both pronation and supination torque. Level of evidence: Case series, Level IV.

scholarly journals Physiology of Acute and Subacute Distal Radioulnar Joint Instability

2006 ◽  
Vol 55 (3) ◽  
pp. 363-367
Author(s):  
Yukio Abe ◽  
Kazunari Tsue ◽  
Kenzo Fujii ◽  
Ryuta Iwanaga
Keyword(s):  
Joint Instability ◽  
Distal Radioulnar Joint ◽  
Radioulnar Joint

Normal Values of Distal Radioulnar Joint Kinematics during a Dynamic Press Test

2021 ◽  
Author(s):  
Janni Kjærgaard Thillemann ◽  
Sepp De Raedt ◽  
Emil Toft Petersen ◽  
Katriina Bøcker Puhakka ◽  
Torben Bæk Hansen ◽  
...  
Keyword(s):  
Normal Values ◽  
Intraclass Correlation ◽  
Case Series ◽  
Distal Radioulnar Joint ◽  
Ulnar Variance ◽  
Patient Specific ◽  
Imaging Method ◽  
Radioulnar Joint ◽  
Case Series Study ◽  
The Press

Abstract Background Measurement of in vivo distal radioulnar joint (DRUJ) pathomechanics during simple activities can represent the disability experienced by patients and may be useful in diagnostics of DRUJ instability. A first step is to describe the physiological normal limits for DRUJ kinematics in a reproducible and precise test setup, which was the aim of this study. Methods DRUJ kinematics were evaluated in 33 participants with dynamic radiostereometry (RSA) while performing a standardized press test examination. AutoRSA software was used for image analyses. Computed tomography (CT) forearm bone models were generated, and standardized anatomical axes were applied to estimate kinematic outcomes including, DRUJ translation, DRUJ position ratio, and changes in ulnar variance. Repeatability of dynamic RSA press test double examinations was evaluated to estimate the precision and intraclass correlation coefficient (ICC) test–retest agreement. Results The maximum force during the press test was 6.0 kg (95% confidence interval [CI]: 5.1–6.9), which resulted in 4.7 mm (95% CI: 4.2–5.1) DRUJ translation, DRUJ position ratio of 0.40 (95% CI: 0.33–0.44), and increase in ulnar variance of 1.1 mm (95% CI: 1.0–1.2). The mean maximum DRUJ translation leveled off after a 5 kg force application. The DRUJ translation ICC coefficient was 0.93 within a prediction interval of ± 0.53mm. Conclusions This clinical study demonstrates the normal values of DRUJ kinematics and reports excellent agreement and high precision of the press tests examination using an automated noninvasive dynamic RSA imaging method based on patient-specific CT bone models. The next step is the application of the method in patients with arthroscopic verified triangular fibrocartilage complex injuries. Level of Evidence This is a Level IV, case series study.

scholarly journals Radius distraction could contribute to long-term stability for treating distal radioulnar joint instability during volar plating of distal radius fracture: a retrospective case series study

2021 ◽  
Author(s):  
Cheng-Yu Yin ◽  
Hui-Kuang Huang ◽  
Duretti Fufa ◽  
Jung-Pan Wang
Keyword(s):  
Surgical Technique ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Case Series ◽  
Distal Radioulnar Joint ◽  
Radius Fracture ◽  
Radioulnar Joint ◽  
Druj Instability

Abstract BackgroundThe surgical technique of radius distraction for stabilization of distal radioulnar joint (DRUJ) if intraoperative DRUJ instability was found after the fixation of distal radius fracture has been previously described, but this surgical technique lacks clinical and radiographic effect in minimal 3 years follow-up. We therefore evaluated the clinical outcome and radiographic results of radius distraction in minimal 3 years follow-up.MethodsWe reviewed the case series of distal radius fracture with concomitant DRUJ instability receiving radius distraction from the senior author over a 5-year period (January 1st, 2013 to June 30th, 2017) retrospectively, and the evaluation of clinical and radiographic outcomes was performed at clinic as long-term follow-up; a total 34 patients had been evaluated.ResultsAt minimal post-operative 36 months follow-up, all cases demonstrated acceptable wrist range of motion with stable DRUJs and low NRS of wrist pain (0.6, SD 0.7) and DASH score (mean 9.1, SD 6.2), and there were no cases suffering from nonunion of distal radius. The mean ulnar variance of injured wrist and uninjured wrist were − 1.2 mm and 0.2mm, respectively (SD 1.0 and 0.6) with significant statistical difference.ConclusionsRadius distraction during volar fixation of distal radius fracture should be consider if DRUJ instability was found by the radioulnar stress test intraoperatively, and the long-term DRUJ stability could be achieved by maintenance of normal-to-negative ulnar variance, with decreased wrist pain and satisfactory function outcome.Level of EvidenceTherapeutic Level IV

scholarly journals Anatomic Reconstruction of the Triangular Fibrocartilage Complex for the Treatment of Chronic Instability of the Distal Radioulnar Joint. A Systematic Review

2021 ◽  
Vol 49 (02) ◽  
pp. e97-e104
Author(s):  
Ignacio Miranda ◽  
Francisco J. Lucas ◽  
Vicente Carratalá ◽  
Joan Ferràs-Tarragó ◽  
Francisco J. Miranda
Keyword(s):  
Systematic Review ◽  
Surgical Techniques ◽  
Case Series ◽  
Distal Radioulnar Joint ◽  
Triangular Fibrocartilage Complex ◽  
Anatomic Reconstruction ◽  
Wrist Arthroscopy ◽  
Radioulnar Joint ◽  
Druj Instability ◽  
Triangular Fibrocartilage

Abstract Introduction Peripheral injuries of the triangular fibrocartilage complex (TFCC) can produce pain and instability of the distal radioulnar joint (DRUJ). There are several techniques for the reconstruction of the TFCC. The aim of the present paper was to summarize the tendon plasties of the DRUJ ligaments for the anatomic reconstruction of TFCC, to analyze the surgical techniques, and to evaluate their outcomes. Methods In order to perform a systematic review, we searched in the literature the terms DRUJ instability OR chronic distal radioulnar joint instability OR distal radioulnar tendon plasty. Results In total, 11 articles with level of evidence IV (case series) were retrieved. Most studies achieved good results, with recovery of wrist stability, improvement of the pain, and increase in grip strength in the functionality tests. In the historical evolution of the published series, wrist surgeons tried to perform a more anatomical plasty, with a more stable fixation and less invasive techniques. Conclusion The Adams procedure continues to be a valid and reproducible technique for the treatment of chronic DRUJ instability. If wrist arthroscopy and implants are available and surgeons have been technically trained, the authors recommend an arthroscopy-assisted technique, or, if possible, an all-arthroscopic TFCC reconstruction with implant fixation of the plasty in its anatomical points of insertion. Comparative studies between open and arthroscopic TFCC reconstruction techniques are needed.

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