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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

When the radius rotates around the ulna in pronation, thedorsal superficial fibers tighten, as do the deep palmar fibers.
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F6a: When the radius rotates around the ulna in pronation, thedorsal superficial fibers tighten, as do the deep palmar fibers.

Mentions: The primary intrinsic stabilizer of the DRUJ is the TFCC, predominantly the radioulnar ligaments of the TFCC. Additional stability is provided by the DRUJ capsule, which allows pronosupination without anterioposterior luxation. Early theories about the effect of the TFCC on DRUJ stability, suggested unique, non-collaborating roles for both deep and superficial radioulnar fibers [1,20]. Hagert stated that in pronation, the dorsal superficial fibers tighten, as do the deep palmar fibers. Conversely, in supination, the palmar superficial radioulnar fibers tighten, as do the deep dorsal fibers [10] (Fig. 6a, b).


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

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

When the radius rotates around the ulna in pronation, thedorsal superficial fibers tighten, as do the deep palmar fibers.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

F6a: When the radius rotates around the ulna in pronation, thedorsal superficial fibers tighten, as do the deep palmar fibers.
Mentions: The primary intrinsic stabilizer of the DRUJ is the TFCC, predominantly the radioulnar ligaments of the TFCC. Additional stability is provided by the DRUJ capsule, which allows pronosupination without anterioposterior luxation. Early theories about the effect of the TFCC on DRUJ stability, suggested unique, non-collaborating roles for both deep and superficial radioulnar fibers [1,20]. Hagert stated that in pronation, the dorsal superficial fibers tighten, as do the deep palmar fibers. Conversely, in supination, the palmar superficial radioulnar fibers tighten, as do the deep dorsal fibers [10] (Fig. 6a, b).

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