[A case control study on the treatment of distal radioulnar joint instability combined with distal radius fractures between fixation and non-fixation distal radioulnar joint]

Abstract

Objective: To explore the options on treatment of distal radioulnar joint instability combined with distal radius fracture.

Methods: From June 2007 to December 2009, 264 patients with unstable distal radius fractures were treated with open reduction and internal fixation, in which 42 patients combined with distal radioulnar instability. Distal radioulnar joints of 20 patients were fixed with Kirschner wire or plaster cast at supinator position, and other distal radioulnar joints of 22 patients were not fixed. Range of motion of wrist joints and grip strength were observed; function of wrist were evaluated by modified Gartland-Werley scoring system (GW score); stability of distal radioulnar joints were tested at final follow-up.

Results: Forty-one patients were followed up more than 1 year. All fractures obtained healing within 3 months after operation, and apposition of joints was good, no significant subluxation or dislocation were found. There were not statistical differences in grip strength, motion of joints and GW score between two groups (fixation and non-fixation). Only one patient occurred chronic distal radioulnar instability.

Conclusion: There was no significant difference between fixation and non fixation for the treatment of distal radius fractures with distal radioulnar joint instability. For this reason, if fractures can be satisfactory reduced, there is no need for the one-stage distal radioulnar joint fixation.