Loop plate elastic fixation for treatment of distal radioulnar joint dislocation

Abstract

Objective To observe the clinical efficacy of loop plate elastic fixation for treatment of distal radioulnar joint dislocation. Methods From December 2014 to November 2016, 11 patients with distal radioulnar joint dislocation were treated by loop plate elastic fixation. They were 7 males and 5 females, aged from 23 to 56 years (average, 37.5 years). The dislocations were volar in 2 cases, dorsal in 7, transversal in 2 and longitudinal in one. Of them, 6 were complicated with ulnar fracture, 2 with radial fracture and one with radioulnar fracture. All the fractures were closed. Functional outcomes of the wrist were assessed by the Gart-land-Werley scoring system, range of motion and grip strength at the last follow-up. Results The 12 pa-tients were followed up from 6 to 18 months (average, 12 months). Reduction of the distal radioulnar joint dislocation was confirmed in all by the anteroposterior and lateral X-ray films after operation. All the concomitant fractures were healed after 2 to 5 months (average, 3 months). No re-dislocation of the distal radioulnar joint occurred. According to the Garland-Werley scoring at the last follow-up, the functional outcomes of the wrist were excellent in 10 patients, good in one and fair in one. There were no significant differences between the healthy and affected wrists in active range of flextion or extension, radial or unlnar deviation, pronation or supination, or grip strength (P >0.05). No infection, skin necrosis, internal fixation failure, dislocation recurrence or traumatic arthritis was observed during follow-up. The loop plate had to be removed in one case because of soft-tissue irritation. Conclusion Loop plate elastic fixation for distal radioulnar joint dislocation may pro-vide firm fixation as well as preserve physiological micro-motion of the joint, leading to fine functional recovery of the wrist and satisfactory short-term outcomes. Key words: Carpal joints; Dislocation; Fracture fixation, internal; Bone plates