J Korean Soc Surg Hand.  2012 Dec;17(4):147-152. 10.12790/jkssh.2012.17.4.147.

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

• Choi KB
• Huh SW
• Kim SE
• Lee JW
• Song SW
• Rhee SK

• KMID: 1425256
• DOI: http://doi.org/10.12790/jkssh.2012.17.4.147

Abstract

PURPOSE
Distal radius fractures involving distal radioulnar joint (DRUJ) are common. After the fracture treatment, pain on the ulnar side of wrist, limitation of forearm rotation and instabilities can be remained. The purpose of this study was to address the importance of anatomical reduction for DRUJ injuries.
METHODS
Of 115 cases with a distal radius fracture involving DRUJ, 61 cases involving sigmoid notch of the radius or having a ulnar styloid process base fracture were evaluated. At an average of six months follow-up, their final outcomes were investigated using radiologic findings, functional disabilities of the arm, shoulder and hand (DASH) and visual analogue scale (VAS) pain scores and wrist motion of pronation/supination.
RESULTS
Satisfied radiologic reduction rate was 73.8%(45/61) in average, which was most favorable in external fixator group (82.4%, 28/34). The mean functional DASH score was 29.0 points and mean VAS for pain was 5.0. The mean range of wrist motions for pronation/supination was 59.5degrees/55.7degrees.
CONCLUSION
Distal radius fractures involving DRUJ should be classified into the basic categories of unstable distal radius fracture, and immediate anatomical reduction is needed by operative treatment to avoid painful forearm rotation.

Keyword

Distal radioulnar joint injuries

MeSH Terms

Arm
Colon, Sigmoid
External Fixators
Follow-Up Studies
Forearm
Hand
Joints
Radius
Radius Fractures
Shoulder
Wrist

Figure

• 

  Fig. 1 (A) Radiographs of a 45-year-old male patient show distal radius fracture involving ulnar side of radius. (B) Computed tomography shows the fracture extends to distal radioulnar joint line. (C) Anatomical reduction was performed using external fixator and K-wires. (D) At 6 months follow-up, radiograph shows anatomically-reduced state. Painless full wrist range of motion was obtained.

• 

  Fig. 2 (A) Radiographs of a 30-year-old male patient show the fracture line extending distal radioulnar joint and a fracture of distal ulna. (B) Anatomical reduction was performed using K-wires and mini-Acutrak screw. (C) At 4 month follow-up, radiograph shows anatomically-reduced state.

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