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DRUJDistal Radioulnar Joint
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(5) Attention is often focused on the radial head fracture; the associated tear of the IOM and the injury to the DRUJ may be overlooked, delaying diagnosis and treatment.
On postreduction stability testing, the DRUJ was felt to be unstable at 45[degrees] of supination.
[23] It can leads to alterations in normal anatomic and biomechanical relations of distal radius, incongruency at DRUJ and DRCJ with changes in volar tilt and ulnar variance, loss of relative length and rotational deformity, which can finally lead to change in load concentration, shift of forces to volar position, decreased ROM, ulnocarpal impingement, changing the carpal tunnel direction, angulations in the flexor tendons, decreasing the grip strength and leading to post-traumatic arthrosis and diminished function.
Authors have reported TFCC tears in 43-80% of patients following distal radius fractures, with majority of peripheral TFCC tears demonstrating DRUJ instability.
After fixation of the distal radius fracture, an intraoperative decision was made regarding treatment of the distal ulna fracture based upon residual displacement, amount of incongruence of the DRUJ, and degree of instability of the distal ulna.
The patient underwent formal irrigation and debridement of the left DRUJ through a dorsal approach.
Initial radiographs demonstrated a distal radius fracture associated with a severe DRUJ volar dislocation.
The joint surfaces were inspected, and the stability of the DRUJ was determined, while identifying TFCC, or more specifically, articular disk pathology (Fig.
Incidence of various Complications in the study population Malunion 29.80% DRUJ associated with malunion 14% Palmar displacement 10.50% Tendon injuries 3.50% Dorsal displacement 22.80% Neurological complication 12.30% Ulnar side wrist pain 7.10% Note: Table made from pie chart.
Stryker hand plating system was placed in bone slope towards DRUJ, so the edge of this small plate would not extend to the joint surface of DRUJ actually.
(15) In distal radius fracture with unstable DRUJ, Depalma described ulno-radial pinning drilled at 45[degrees] angle, 4cm proximal to ulnar styloid.