Volume 7 | Issue 1 | Jan – April 2019 | Page: 2- 8 | Anil K Bhat, N R Fijad.
Authors: Anil K Bhat , N R Fijad .
 Department Of Orthopaedics, Kasturba Medical College, Manipal, Karnataka, India
Address of Correspondence
Dr. N R Fijad,
Department of Orthopedics,
Kasturba Medical College, Manipal, Karnataka, India
The complex anatomy of distal radioulnar can make diagnosis of this joint problems challenging. Disorders of the DRUJ are a major source of ulnar-sided wrist pain. Stabilization of this joint is provided by both intrinsic and extrinsic stabilizers and the joint capsule. Several clinical tests have been suggested to determine static or dynamic DRUJ stability. Radiologic evaluation of DRUJ instability begins with conventional radiographs .CT-scan seems to be the best additional modality to evaluate the osseous structures. MRI has proven to be more sensitive and specific for TFCC tears, potentially causing DRUJ instability, while arthroscopy is the gold standard for evaluation. Symptomatic DRUJ injuries treatment can be conservative or operative. Operative treatment consist of restoration of osseous and ligamentous anatomy. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Salvage procedures in arthritis is gaining acceptance in the management of arthritis. This review covers various problems affecting the distal radioulnar joint, including fractures and dislocations, triangular fibrocartilage pathology and arthritis.
Keywords: Cadaveric and CT scan study, DRUJ instability, Sigmoid notch morphology.
- Palmer AK, Werner FW. Biomechanics of the Distal Radioulnar Joint. Clinical Orthopaedics and Related Research. 1984; &NA;(187).
- Tolat AR, Sanderson PL, Smet LD, Stanley JK. The Gymnast’s Wrist: Acquired Positive Ulnar Variance Following Chronic Epiphyseal Injury. Journal of Hand Surgery. 1992;17(6):678–81.
- Tolat AR, Stanley JK, Trail IA. A Cadaveric Study of The Anatomy and Stability of The Distal Radioulnar Joint in The Coronal and Transverse Planes. Journal of Hand Surgery. 1996;21(5):587–94
- Tay SC, Tomita K, Berger RA. The “Ulnar Fovea Sign” for Defining Ulnar Wrist Pain: An Analysis of Sensitivity and Specificity. The Journal of Hand Surgery. 2007;32(4):438–44.
- Nakamura T, Yabe Y, Horiuchi Y. Functional Anatomy of The Triangular Fibrocartilage Complex. Journal of Hand Surgery. 1996;21(5):581–6.
- Seo KN, Park MJ, Kang HJ. Anatomic Reconstruction of the Distal Radioulnar Ligament for Posttraumatic Distal Radioulnar Joint Instability. Clinics in Orthopedic Surgery. 2009;1(3):138
- Nakamura R, Horii E, Imaeda T, Tsunoda K, Nakao E. Distal radioulnar joint subluxation and dislocation diagnosed by standard roentgenography. Skeletal Radiology. 1995;24(2).
- Lester B, Halbrecht J, Levy IM, Gaudinez R. “Press Test” for Office Diagnosis of Triangular Fibrocartilage Complex Tears of the Wrist. Annals of Plastic Surgery. 1995;35(1):41–5.
- Mino DE, Palmer AK, Levinsohn FM, Siverman PM. The Role Of Radiography And Computerized Tomography In The Diagnosis Of Subluxation And Dislocation Of The Distal Radioulnar Joint. Journal of Computer Assisted Tomography. 1983;7(6):1135.
- Freedman DM, Dowdle J, Glickel SZ, Singson R, Okezie T. Tomography Versus Computed Tomography for Assessing Step Off in Intraarticular Distal Radial Fractures. Clinical Orthopaedics and Related Research. 1999;361:199–204
- Anderson ML, Skinner JA, Felmlee JP, Berger RA, Amrami KK. Diagnostic Comparison of 1.5 Tesla and 3.0 Tesla Preoperative MRI of the Wrist in Patients with Ulnar-Sided Wrist Pain. The Journal of Hand Surgery. 2008; 33(7):1153–9.
- Kazemian GH, Bakhshi H, Lilley M, Moghaddam MET, Omidian MM, Safdari F, et al. DRUJ instability after distal radius fracture: A comparison between cases with and without ulnar styloid fracture. International Journal of Surgery. 2011;9(8):648–51.
- Rettig ME, Raskin KB. Galeazzi fracture-dislocation: A new treatment-oriented classification. The Journal of Hand Surgery. 2001;26(2):228–35
- Kakar S, Carlsen BT, Moran SL, Berger RA. The management of chronic distal radioulnar instability. Hand Clin 2010; 26: 517e28.
- Petersen MS, Adams BD. Biomechanical evaluation of distal radioulnar reconstructions. J Hand Surg Am 1993; 18: 328e34.
- Adams BD, Berger RA. An anatomic reconstruction of the distal radioulnar ligaments for posttraumatic distal radioulnar joint instability. J Hand Surg Am 2002; 27: 243e51.
- Darrach W, Nolan WB, Eaton RG. Partial Excision of Lower Shaft of Ulna for Deformity Following Colles??s Fracture. Clinical Orthopaedics and Related Research. 1992;&NA;(275).
- Kapandji AI. The Sauvé-Kapandji Procedure. Journal of Hand Surgery. 1992;17(2):125–6.
- White GM, Weiland AJ. Madelungs deformity: Treatment by osteotomy of the radius and Lauenstein procedure. The Journal of Hand Surgery. 1987;12(2):202
- Wood VE, Sauser D, Mudge D. The treatment of hereditary multiple exostosis of the upper extremity. The Journal of Hand Surgery. 1985;10(4):505–13.
|How to Cite this article: Bhat A, Fijad, NR. Distal Radioulnar Joint injuries: Surgical anatomy, physical examination, Imaging and principles of management. J Kar Orth Assoc. Jan-April 2019; 7(1): 2-8.|