scholarly journals The value of computed tomography in detecting distal radioulnar joint instability after a distal radius fracture

2017 ◽  
Vol 42 (5) ◽  
pp. 501-506 ◽  
Author(s):  
R. H. van Leerdam ◽  
M. M. E. Wijffels ◽  
M. Reijnierse ◽  
W. Stomp ◽  
P. Krijnen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Joint Instability ◽  
Stress Test ◽  
Distal Radioulnar Joint ◽  
Radius Fracture ◽  
Radioulnar Joint ◽  
Clinical Instability ◽  
Computed Tomography Scans

This study evaluated the value of computed tomography scans for the diagnosis of distal radioulnar joint instability. A total of 46 patients, conservatively treated for a unilateral distal radius fracture, were evaluated. Clinical instability was tested using the stress test and clunk test. A computed tomography scan of both wrists was performed in pronation and supination. Two independent observers reviewed the computed tomography scans using: the radioulnar line, subluxation ratio, epicentre and radioulnar ratio methods. Radiological distal radioulnar joint instability was assessed by comparing the measurements of the injured wrist with those of the contralateral uninjured wrists. A total of 22 patients had clinical instability of whom 12 suffered from pain in the injured wrist. Distal radioulnar joint instability was diagnosed on computed tomography in 29 patients. Reliability analysis between clinical and radiological evaluations showed at best moderate, but generally poor agreement. The diagnostic ability of computed tomography for identifying distal radioulnar joint instability seems limited. Level of evidence: IV

Radioulnar Ratio in Detection of Distal Radioulnar Joint Instability Associated With Acute Distal Radius Fractures

2010 ◽  
Vol 35 (9) ◽  
pp. 730-734 ◽  
Author(s):  
J.H. Scheer ◽  
S. Hammerby ◽  
L.E. Adolfsson
Keyword(s):  
Computed Tomography ◽  
Prospective Study ◽  
Distal Radius ◽  
Joint Instability ◽  
Stress Test ◽  
Distal Radioulnar Joint ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Radioulnar Joint ◽  
Triangular Fibrocartilage

Lesions of the triangular fibrocartilage complex (TFCC) are commonly associated with distal radius fractures and may adversely affect the functional outcome. This prospective study evaluated computed tomography, using the radioulnar ratio (RUR), to detect laxity of the distal radioulnar joint in 48 consecutive patients with acute distal radius fractures and compared the results with a radioulnar stress test. We found the clinical stress test to be reliable in chronic cases, but the RUR method of questionable value in both acute and chronic cases.

Radioulnar laxity and clinical outcome do not correlate after a distal radius fracture

2011 ◽  
Vol 36 (6) ◽  
pp. 503-508 ◽  
Author(s):  
J. H. Scheer ◽  
L. E. Adolfsson
Keyword(s):  
Clinical Outcome ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Stress Test ◽  
Distal Radioulnar Joint ◽  
Radius Fracture ◽  
Radioulnar Joint ◽  
Significant Difference ◽  
Triangular Fibrocartilage ◽  
Clinically Significant

Injury to the triangular fibrocartilage complex associated with distal radius fracture may cause symptoms of ulnar instability. Assessed by a radioulnar stress test, increased laxity of the distal radioulnar joint has in two previous studies been depicted to be associated with poorer outcome. This prospective study of 40 adults investigates the correlation of this test with functional outcome as measured by DASH. No clinically significant difference was found in relation to this test at two and five years after injury. Therefore using this test alone to decide whether or not to perform an acute repair of the TFCC cannot be recommended.

In vivo measurement of distal radioulnar translation following distal radius fracture

2021 ◽  
pp. 175319342110166
Author(s):  
Grey E. B. Giddins ◽  
Greg T. Pickering
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Distal Radioulnar Joint ◽  
Wrist Fracture ◽  
Radius Fracture ◽  
Normal Range ◽  
Radioulnar Joint ◽  
In Vivo Measurement ◽  
Objectively Measured

The incidence of distal radioulnar joint instability following a distal radius fracture is estimated around one in three based upon clinical examination. Using a validated rig, we objectively measured distal radioulnar joint translation in vivo following distal radius fracture. Dorsopalmar translation of the distal radioulnar joint was measured in 50 adults with previous distal radius fractures. Measurements were compared with the uninjured wrist and against a database of previous measurements within healthy and clinically lax populations. Translation at the distal radioulnar joint was greater in injured wrists at 12.2 mm (range 10–15, SD 1.2) than the uninjured wrists at 6.4 (range 4–9, SD 0.8) ( p < 0.001) and was always outside the established normal range. There was no statistically significant link between translation and the severity of the injury. Instability appears almost inevitable following a distal radius (wrist) fracture, albeit subclinical in the vast majority.

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