Concomitant Distal Radioulnar Joint Disruption in Distal End Radius Fracture Cases Admitted to Emergency Ward Hasan Sadikin Hospital January 2013 – December 2015

Tody Pinandita,Yoyos Dias Ismiarto,Herry Herman

doi:10.20527/jbk.v15i1.6090

Abstract

Abstract: The distal end radius and ulna is an integral part of the wrist joint and preservation of its normal anatomy is essential for the mobility of the wrist. The most common cause of residual wrist disability after distal end radius fractures is the disruption of distal radioulnar joint (DRUJ). Early recognition and management in the acute stage aim at the anatomic reconstruction of the DRUJ in an effort to reduce incidence of chronic pain and loss of wrist motion. The purpose of this study is to identify the prevalence of accompanying DRUJ in distal end radius fracture cases, highlighting its significance in occurance. This was a retrospective study with an analytic descriptive method and data from January 2013-December 2015 taken from medical records of Dr. Hasan Sadikin Hospital. From research, we found 74 cases of distal end radius fracture. The most common injured wrist were dominant hand as 46 cases (62,2%), and non-dominant hand as 28 cases (37,8%). From all data, DRUJ disruption were marked as 37 cases (50%). Extraarticular fracture with concomitant DRUJ disruption were marked in 3 cases (8,1%) and in intraarticular involvement were 34 cases (91,9 %). From this study, we can conclude that half of the distal end radius fracture cases, especially intraarticular, were accompanied by DRUJ disruption. This should be an issue to be concerned by the physician when evaluating distal end radius fracture cases and to perform proper treatment.

Highlights

A fracture of the distal end radius is a very frequent fracture, estimated at up to 20% of all cases of fractures handled at the emergency department.[1,2,3,4] This fracture can occur in all age groups, both old and young
Distal radioulnar joint (DRUJ) disruption diagnosed by assessing the widening distance distal radioulnar more than 4 mm and the ulnar variance greater than 2 mm are rated from x-ray plain anteroposterior wrist, as well as the dislocation or subluxation to the dorsal ulnar head assessed from x-ray plain lateral wrist, and a displaced fracture of the ulnar base styloid
Good clinical examination and rigorous radiological assessment should be performed in each case of distal radius fracture, to find out whether there is an accompanying abnormality in the DRUJ, because most of the distal end radius fracture especially involving intraarticular were accompanied with DRUJ disruption

Summary

Introduction

A fracture of the distal end radius is a very frequent fracture, estimated at up to 20% of all cases of fractures handled at the emergency department.[1,2,3,4] This fracture can occur in all age groups, both old and young. The cause of this fracture varies, not necessarily caused by traffic accidents (high energy), but a person who fell from a height equivalent to a standing position can experience this fracture. Ulnar heads articulate with sigmoid notch distal radius and the congruence between the two provide stability for DRUJ, but this articulation is very shallow and requires additional stability derived from soft tissue to maintain its position.[6,7,8]

Objectives

Methods

Results

Conclusion