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Clinical and non-clinical aspects of distal radioulnar joint instability.

Wijffels M, Brink P, Schipper I - Open Orthop J (2012)

Bottom Line: MRI has proven to be more sensitive and specific for TFCC tears, potentially causing DRUJ instability.Symptomatic DRUJ injuries treatment can be conservative or operative.If not successful, salvage procedures can be performed to regain stability.

View Article: PubMed Central - PubMed

Affiliation: Leiden University Medical Center, Department of Surgery-Traumatology, P.O. Box 9600, 2300 RC Leiden, The Netherlands.

ABSTRACT
Untreated distal radioulnar joint (DRUJ) injuries can give rise to long lasting complaints. Although common, diagnosis and treatment of DRUJ injuries remains a challenge. The articulating anatomy of the distal radius and ulna, among others, enables an extensive range of forearm pronosupination movements. Stabilization of this joint is provided by both intrinsic and extrinsic stabilizers and the joint capsule. These structures transmit the load and prevent the DRUJ from luxation during movement. Several clinical tests have been suggested to determine static or dynamic DRUJ stability, but their predictive value is unclear. Radiologic evaluation of DRUJ instability begins with conventional radiographs in anterioposterior and true lateral view. If not conclusive, 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. DRUJ instability may remain asymptomatic. Symptomatic DRUJ injuries treatment can be conservative or operative. Operative treatment should consist of restoration of osseous and ligamenteous anatomy. If not successful, salvage procedures can be performed to regain stability.

No MeSH data available.


Related in: MedlinePlus

The dorsal and palmar radioulnar fibers originate from themedial border of the distal radius and insert on the ulna at twodistinct sites; deep fibers at the ulnar fovea and superficial fibers atthe ulnar styloid.
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Figure 4: The dorsal and palmar radioulnar fibers originate from themedial border of the distal radius and insert on the ulna at twodistinct sites; deep fibers at the ulnar fovea and superficial fibers atthe ulnar styloid.

Mentions: The disc is a strong fibrocartilage structure, stretched between ulna and radius proximally and lunate and triquetral bones distally. The base of the disc is attached to the distal edge of the sigmoid notch; the incisura ulnaris radii. The apex of the disc is inserted to the depressed area of the ulnar head; the basistyloid fovea. It is continuous with the ulnar collateral ligament. On the volar side the disc is continuous with the ulnocarpal ligament, inserting on the lunate, triquetral and capitate bones [7,8]. The dorsal and palmar radioulnar fibers originate from the medial border of the distal radius and insert on the ulna at two distinct sites; deep fibers at the ulnar fovea and superficial fibers at the ulnar styloid (Fig. 4).


Clinical and non-clinical aspects of distal radioulnar joint instability.

Wijffels M, Brink P, Schipper I - Open Orthop J (2012)

The dorsal and palmar radioulnar fibers originate from themedial border of the distal radius and insert on the ulna at twodistinct sites; deep fibers at the ulnar fovea and superficial fibers atthe ulnar styloid.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3367466&req=5

Figure 4: The dorsal and palmar radioulnar fibers originate from themedial border of the distal radius and insert on the ulna at twodistinct sites; deep fibers at the ulnar fovea and superficial fibers atthe ulnar styloid.
Mentions: The disc is a strong fibrocartilage structure, stretched between ulna and radius proximally and lunate and triquetral bones distally. The base of the disc is attached to the distal edge of the sigmoid notch; the incisura ulnaris radii. The apex of the disc is inserted to the depressed area of the ulnar head; the basistyloid fovea. It is continuous with the ulnar collateral ligament. On the volar side the disc is continuous with the ulnocarpal ligament, inserting on the lunate, triquetral and capitate bones [7,8]. The dorsal and palmar radioulnar fibers originate from the medial border of the distal radius and insert on the ulna at two distinct sites; deep fibers at the ulnar fovea and superficial fibers at the ulnar styloid (Fig. 4).

Bottom Line: MRI has proven to be more sensitive and specific for TFCC tears, potentially causing DRUJ instability.Symptomatic DRUJ injuries treatment can be conservative or operative.If not successful, salvage procedures can be performed to regain stability.

View Article: PubMed Central - PubMed

Affiliation: Leiden University Medical Center, Department of Surgery-Traumatology, P.O. Box 9600, 2300 RC Leiden, The Netherlands.

ABSTRACT
Untreated distal radioulnar joint (DRUJ) injuries can give rise to long lasting complaints. Although common, diagnosis and treatment of DRUJ injuries remains a challenge. The articulating anatomy of the distal radius and ulna, among others, enables an extensive range of forearm pronosupination movements. Stabilization of this joint is provided by both intrinsic and extrinsic stabilizers and the joint capsule. These structures transmit the load and prevent the DRUJ from luxation during movement. Several clinical tests have been suggested to determine static or dynamic DRUJ stability, but their predictive value is unclear. Radiologic evaluation of DRUJ instability begins with conventional radiographs in anterioposterior and true lateral view. If not conclusive, 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. DRUJ instability may remain asymptomatic. Symptomatic DRUJ injuries treatment can be conservative or operative. Operative treatment should consist of restoration of osseous and ligamenteous anatomy. If not successful, salvage procedures can be performed to regain stability.

No MeSH data available.


Related in: MedlinePlus