Injuries of the distal radioulnar joint

Area of Science:

• Orthopedic Surgery
• Upper Extremity Injuries
• Radioulnar Joint Biomechanics

Background:

• Distal radioulnar (DRU) joint injuries are common but frequently overlooked, often associated with other upper limb trauma.
• Instability or incongruity of the DRU joint necessitates restoring anatomical alignment and stability for optimal function.

Purpose of the Study:

• To review acute and chronic abnormalities of the DRU joint and discuss treatment strategies.
• To differentiate DRU joint dysfunction from ulnar impingement and outline management approaches.
• To provide age-specific treatment recommendations for DRU joint dysfunction.

Main Methods:

• Review of acute and chronic DRU joint injuries and their management.
• Discussion of surgical techniques including ulnar shortening, Darrach procedure, and resection arthroplasty.
• Consideration of corrective osteotomy and soft tissue reconstruction for malunions involving the DRU joint.

Main Results:

• Appropriate diagnosis and management of acute DRU joint injuries yield higher success rates than reconstructive procedures for chronic conditions.
• Ulnar shortening is a common treatment for ulnar impingement against the carpus.
• Age-specific treatments for DRU joint dysfunction include the Darrach procedure for elderly patients and resection arthroplasty for younger patients, preserving key anatomical structures.

Conclusions:

• Timely and accurate diagnosis of DRU joint injuries is crucial for successful treatment outcomes.
• Treatment strategies for DRU joint disorders should be tailored to the specific condition (dysfunction vs. impingement) and patient age.
• Preservation of the triangular fibrocartilage complex (TFCC) and ulnar length is emphasized in younger patients undergoing DRU joint surgery.