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 Evaluation of an Image-Based Tool to Examine the Effect of Fracture Alignment and Joint Congruency on Outcomes after Wrist Fracture

2015 ◽  
Vol 9 (1) ◽  
pp. 168-178 ◽  
Author(s):  
Emily A Lalone ◽  
Ruby Grewal ◽  
Graham W King ◽  
Joy C MacDermid
Keyword(s):  
Distal Radius Fracture ◽  
Clinical Outcomes ◽  
Distal Radius ◽  
Distal Radioulnar Joint ◽  
Radius Fracture ◽  
Joint Congruency ◽  
Radioulnar Joint ◽  
Pain Disability ◽  
Post Traumatic

Some mal-alignment of the wrist occurs in up to 71% of patients following a distal radius fracture. A multiple case study was used to provide proof of principle of an image-based technique to investigate the evolution and impact of post-traumatic joint changes at the distal radioulnar joint. Participants who had a unilateral distal radius fracture who previously participated in a prospective study were recruited from a single tertiary hand center. Long term follow-up measures of pain, disability, range of motion and radiographic alignment were obtained and compared to joint congruency measures. The inter-bone distance, a measure of joint congruency was quantified from reconstructed CT bone models of the distal radius and ulna and the clinical outcome was quantified using the patient rated wrist evaluation. In all four cases, acceptable post-reduction alignment and minimal pain/disability at 1-year suggested good clinical outcomes. However, 10 years following injury, 3 out of 4 patients had radiographic signs of degenerative changes occurring in their injured wrist (distal radioulnar joint/radio-carpal joint). Proximity maps displaying inter-bone distances showed asymmetrical congruency between wrists in these three patients. The 10-year PRWE (patient rated wrist evaluation) varied from 4 to 60, with 3 reporting minimal pain/disability and one experiencing high pain/disability. These illustrative cases demonstrate long-term joint damage post-fracture is common and occurs despite positive short-term clinical outcomes. Imaging and functional outcomes are not necessarily correlated. A novel congruency measure provides an indicator of the overall impact of joint mal-alignment that can be used to determine predictors of post-traumatic arthritis and is viable for clinical or large cohort studies.

Distal Radius Fracture Treatment Outcomes in Patients With Ipsilateral Hemiplegia or Hemiparesis

Hand ◽  
2021 ◽  
pp. 155894472199973
Author(s):  
Nicholas Munaretto ◽  
Adam Tagliero ◽  
Raahil Patel ◽  
Peter C. Rhee
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Case Series ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Functional Classification ◽  
Radius Fractures ◽  
Radiographic Outcomes ◽  
Ipsilateral Hemiparesis

Background Little information exists to guide decision-making with regard to distal radius fractures in the setting of ipsilateral hemiparesis or hemiplegia. Methods Patients who sustained a distal radius fracture in the setting of ipsilateral hemiparesis or hemiplegia secondary to brain injury were evaluated. Investigated variables included perioperative pain, preinjury House functional classification score, length of immobilization, radiographic outcome measurements, and time to union. Results There were 15 patients with distal radius fractures with a mean age of 65.9 years. The mean clinical and radiographic follow-up was 2.8 and 2.9 years, respectively. Wrists were placed into the nonoperative group (NOG, n = 10) and operative group (OG, n = 5). Pain significantly decreased at final follow-up for both groups. Baseline House functional classification scores averaged 1.3 and 1.6 for the NOG and OG, respectively, and were maintained at final follow-up. Length of immobilization for the NOG was 46 days and OG was 37 days, P = .15. Radiographic outcomes at final follow-up in the NOG and OG, respectively, were a mean radial height of 9.3 versus. 11.6 mm, radial inclination of 18.3° versus 22.3°, 4.2° dorsal tilt versus 5.3° volar tilt, and tear drop angle of 45.6° versus 44.5°. There were no significant differences in these measurements. Time to radiographic union averaged 58 days for the NOG and 67 days for the OG, P = .42. There were no revision surgeries. Conclusions Based on this small case series, patients with distal radius fracture and ipsilateral hemiparesis or hemiplegia may have similar clinical, functional, and radiographic outcomes, regardless of nonoperative or operative treatment.

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.

scholarly journals Volar Distal Radioulnar Joint Dislocation Associated with Acute Median Nerve Neuropathy and a Distal Radius Fracture

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Naser Alnusif ◽  
Sultan Aldebeyan ◽  
Rudolf Reindl
Keyword(s):  
Median Nerve ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Rare Case ◽  
Case Reports ◽  
Carpal Tunnel Release ◽  
Distal Radioulnar Joint ◽  
Radius Fracture ◽  
Radioulnar Joint ◽  
Median Nerve Neuropathy

Volar distal radioulnar (DRUJ) dislocations are uncommon and can easily be missed. We present a rare case of an irreducible volar DRUJ dislocation associated with a distal radius fracture and acute median nerve neuropathy at the wrist. An attempt to reduce the DRUJ dislocation in the emergency department had failed. The patient was then taken to the operating room requiring a carpal tunnel release, as well as an open reduction and internal fixation of the distal radius fracture and repair of the volar distal radioulnar ligament. We also review some of the volar DRUJ case reports in the literature.

Treatment of Distal Radioulnar Joint Injuries Associated with a Distal Radius Fracture

2012 ◽  
Vol 17 (4) ◽  
pp. 147
Author(s):  
Ki-Bum Choi ◽  
Sung-Woo Huh ◽  
Seong-Eun Kim ◽  
Jung-Woo Lee ◽  
Seok-Whan Song ◽  
...  
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Distal Radioulnar Joint ◽  
Radius Fracture ◽  
Radioulnar Joint ◽  
Joint Injuries

scholarly journals SAUVE - KAPANDJI PROCEDURE FOR MALUNITED DISTAL RADIUS FRACTURE: A CASE REPORT

2015 ◽  
Vol 05 (02) ◽  
pp. 061-062
Author(s):  
Sanath Kumar Shetty ◽  
Joseph John ◽  
Lawrence John Mathias ◽  
H Ravindranath Rai
Keyword(s):  
Case Report ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Distal Radioulnar Joint ◽  
Wrist Pain ◽  
Radius Fracture ◽  
Wrist Motion ◽  
Radioulnar Joint ◽  
Triangular Fibrocartilage ◽  
The Right

AbstractDistal radioulnar joint disorders are a frequent cause of wrist pain and instability. The etiology include displaced fractures or malunions of the distal radius and tears of the triangular fibrocartilage complex with DRUJ instability.A 47 year old gentleman presented to us with complaints of pain and deformity of the right wrist of one and half years duration. Radiographs revealed a malunited distal radius fracture.He underwent Sauve Kapandji procedure. Follow ups were done at periodic intervals and wrist physiotherapy was instituted. He had acceptable wrist motion at six weeks.

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