Radial shaft fracture obliquity as a predictor of distal radioulnar joint instability

Ding, Benjamin Tze Keong; Pillay, Kaamini; Sechachalam, Sreedharan

doi:10.1177/1753193418756591

Cited by 7 publications

(4 citation statements)

References 38 publications

(55 reference statements)

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“…However, the extent of ulnar styloid base fractures' contribution to limitations in forearm rotation, wrist pain, and the development of distal radioulnar joint instability is not well-established, and there is a lack of extensive research in this area [10,11]. Many authors have suggested that one of the reasons for achieving suboptimal outcomes in distal radius fractures is the presence of ulnar styloid fractures [3]. This assertion is based on the fact that the triangular fibrocartilage complex (TFCC) originates from the ulnar styloid base, and repairing ulnar styloid base fractures may potentially restore distal radioulnar joint stability [12].…”

Section: Discussionmentioning

confidence: 99%

“…The TFCC facilitates the coordinated movement and function of the distal radius, ulnar head, and proximal row of carpal bones. Consequently, a fractured ulnar styloid is believed to potentially lead to instability and the development of pain in the distal radioulnar joint [2][3][4]. The impact of ulnar styloid fractures on functional outcomes remains uncertain.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of clinical outcomes of conservatively treated type 5 and type 6 fractures in distal radius according to frykman classification

Safalı,

Durgut

2023

Eu Clin Anal Med

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Aim: Distal radius fractures are among the most common upper extremity fractures and are often associated with ulnar styloid fractures. Ulnar styloid fractures can potentially lead to instability and pain in the distal radioulnar joint. This retrospective study aims to investigate the clinical and radiological effects of ulnar styloid fractures in conjunction with distal radius fractures. Material and Methods: In this retrospective study, 64 (group 1: 33 patients, group 2: 31 patients) patients with distal radius fractures were enrolled. Specifically, patients with type 5 and type 6 fractures, according to the Frykman classification, were included in the study from January 2016 to December 2022. All patients in this study received conservative treatment at Selcuk University Orthopaedics Clinic. Results: Furthermore, there were no significant differences observed between the groups in terms of fracture type, range of motion, pain and instability in the distal radioulnar joint (DRUJ), grip strength, Visual Analog Scale (VAS) scores, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, as well as Gartland-Werley and Green & O'Brien tests. Comparison of clinical and radiological parameters between the groups revealed no statistically significant differences. Discussion: The impact of ulnar styloid fractures on distal radius fractures is not fully illuminated in the literature. While it is claimed that styloid fractures may affect the TFCC and that ulnar-sided pain could be persistent, opposing views suggest that the outcome remains unchanged. In our study, our radiological and functional comparisons also indicated that the result did not change statistically. In summary, regardless of whether an ulnar styloid fracture accompanies distal radius fractures, it does not appear to significantly impact the outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of clinical outcomes of conservatively treated type 5 and type 6 fractures in distal radius according to frykman classification

Safalı,

Durgut

2023

Eu Clin Anal Med

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“…4,22 Trauma has been identified as the major cause of Galeazzi fractures, specifically via motor vehicle accidents, sports, and falling injuries. 5,20,26 There has been a reported bimodal distribution of radial and ulnar shaft fracture between young men (age 10-20) and older women (age 60+), but overall, forearm shaft fractures occur predominantly in men across all age groups. [27][28][29] Studies have indicated open fractures to occur in less than 10% of isolated radial shaft fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Tsismenakis and Tornetta 14 similarly found that radial shaft fractures distally located (<7.5 cm from wrist) and radial shortening predict DRUJ instability. Ding et al 20 found that radial shaft fracture obliquity >30° had a high sensitivity for detecting DRUJ instability. In addition, ulnar variance greater than 2 mm and ulnar styloid fractures also play a role associated with DRUJ.…”

Section: Discussionmentioning

confidence: 99%

Higher-Than-Expected Rates of Distal Radioulnar Joint Fixation in Radial Shaft Fractures: Location of Fracture Matters

Zhang

Samineni

Sing

et al. 2021

Hand (New York, N,Y.)

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Background: The purpose of this study was to evaluate rates of distal radioulnar joint (DRUJ) fixation based on location of the radial shaft fracture and risk factors associated with postoperative complications following radial shaft open reduction internal fixation (ORIF). Methods: Adult patients who underwent isolated radial shaft ORIF from 2014 to 2018 were identified from American College of Surgeons National Surgical Quality Improvement Program database and stratified by fracture location and by the presence or absence of DRUJ fixation. Preoperative patient characteristics and postoperative complications were compared to determine risk factors associated with DRUJ fixation. Results: We identified 1517 patients who underwent isolated radial shaft ORIF, of which 396 (26.1%) underwent DRUJ fixation. Preoperative patient characteristics and postoperative complications were similar between cohorts. Distal radioulnar joint fixation was performed in 50 (30.7%) of 163 distal radial shaft fractures, 191 (21.8%) of 875 midshaft fractures, and 3 (13.0%) of 23 proximal shaft fractures ( P = .025). Risk factors for patients readmitted include male sex (odds ratio [OR] = 12.76, P = .009) and older age (OR = 4.99, P = .035). Risk factors for patients with any postoperative complication include dependent functional status (OR = 6.78, P = .02), older age (50-69 vs <50) (OR = 2.73, P = .05), and American Society of Anesthesiologists (ASA) ≥3 (OR = 2.45, P = .047). Conclusions: The rate of DRUJ fixation in radial shaft ORIF exceeded previously reported rates of concomitant DRUJ injury, especially among distal radial shaft fractures. More distally located radial shaft fractures are significantly associated with higher rates of DRUJ fixation. Male sex is a risk factor for readmission, whereas dependent functional status, older age, and ASA ≥3 are risk factors for postoperative complications.

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Forearm Fractures

CCPA

Poolman

2021

Evidence‐Based Orthopedics

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Radial shaft fracture obliquity as a predictor of distal radioulnar joint instability

Abstract: III.

Cited by 7 publications

References 38 publications

Comparison of clinical outcomes of conservatively treated type 5 and type 6 fractures in distal radius according to frykman classification

Comparison of clinical outcomes of conservatively treated type 5 and type 6 fractures in distal radius according to frykman classification

Higher-Than-Expected Rates of Distal Radioulnar Joint Fixation in Radial Shaft Fractures: Location of Fracture Matters

Forearm Fractures

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