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Operative Stabilization of Distal Radius Fractures Presenting With Ulnar Head Subluxation/Dislocation Addresses
James Barger1, Santiago Lasa2, Alberto Fernandez Dell'Oca2
1Department of Orthopedic Surgery, Division of Hand and Upper Extremity, Massachusetts General Hospital, Boston, MA; and.
Ulnar head subluxation/dislocation is uncommon in distal radius fractures. Surgical stabilization of the radius fracture effectively manages these injuries with excellent long-term outcomes.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Radiology
Background:
- Distal radius fractures are common injuries.
- Ulnar head subluxation/dislocation can complicate these fractures.
- Understanding the incidence and management is crucial.
Purpose of the Study:
- Determine the prevalence of ulnar head subluxation/dislocation in distal radius fractures.
- Discuss management strategies and surgical outcomes.
- Correlate findings with relevant wrist anatomy.
Main Methods:
- Retrospective review of 271 patients with displaced distal radius fractures.
- Assessed for ulnar head subluxation/dislocation using Mino criteria.
- Postoperative imaging (CT, radiographs) evaluated joint reduction and healing.
- Functional outcomes (ROM, pain, limitation) documented.
Main Results:
- 8 cases (2.95%) of pre-reduction distal radioulnar joint (DRUJ) subluxation/dislocation identified.
- All treated with open reduction and internal fixation (ORIF) of the distal radius.
- Postoperative imaging showed stable DRUJ in all cases.
- Excellent range of motion and functional outcomes at long-term follow-up.
Conclusions:
- Ulnar head subluxation/dislocation is an infrequent complication of distal radius fractures.
- Operative stabilization of the distal radius fracture is often sufficient for management.
- Effective treatment leads to stable DRUJ and good functional recovery.
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