Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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A Comparison of the Effectiveness of Fixing the Distal Radioulnar Joint (DRUJ) Versus Non-Surgical Management in Patients with an Extra-articular Distal Radius Fracture
Pothuri Rishi Ram, Praveen Narayan and B. Raghunath Reddy
Page: 751-756 | Received 12 Jul 2023, Published online: 04 Aug 2023
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Abstract
Fractures of the distal radius are highly prevalent, accounting for a significant proportion of emergency department visits. Among patients seeking treatment for fractures, approximately one in six individuals are diagnosed with distal radius fractures. Managing these fractures presents a challenge due to the potential for undetected instability in the distal radio‐ulnar joint (DRUJ), which can have a negative impact on the outcome. Reported frequencies of DRUJ instability one year after distal radius fractures vary widely, ranging from 2‐37%. This study was conducted at the Sanjay Gandhi Institute of Trauma and Orthopaedics, involving 50 cases. The participants included individuals with extra‐articular distal radius fractures and concurrent DRUJ instability, while those with open or bilateral distal radius fractures were excluded. Treatment options for the distal radius fractures consisted of plating or k‐wire fixation, while management of DRUJ instability involved either conservative measures or k‐wire fixation. Follow‐up assessments were conducted at one month, three months, six months and one year post surgery, utilizing the Gartland and Werley scoring system to evaluate treatment effectiveness. The study encompassed a total of 50 patients, with 35 males and 15 females. Among them, 25 patients were managed conservatively, while the other 25 received k‐wire fixation for DRUJ instability. In the conservative group, six patients achieved an excellent outcome and nine had a good outcome. In the k‐wire group, four patients attained an excellent outcome and ten had a good outcome. Poor results were observed in three patients in the conservative group and two in the k‐wire group. No notable difference in functional outcomes was observed between the two groups. A few complications were reported, including pin tract infections and wrist joint stiffness. Distal radius fractures commonly result in instability of the distal radio‐ulnar joint (DRUJ). Intraoperative testing is the most reliable method for diagnosing DRUJ instability following fixation of distal radius fractures. The main objective of treating DRUJ instability is to restore painless supination and pronation activities, facilitating daily living tasks. Conservative management with a plaster of Paris (POP) cast and k‐wire fixation are the commonly employed treatments for DRUJ instability. This study suggests that both conservative management and k‐wire fixation yield similar outcomes for DRUJ instability following distal radius fractures.
How to cite this article:
Pothuri Rishi Ram, Praveen Narayan and B. Raghunath Reddy. A Comparison of the Effectiveness of Fixing the Distal Radioulnar Joint (DRUJ) Versus Non-Surgical Management in Patients with an Extra-articular Distal Radius Fracture.
DOI: https://doi.org/10.36478/10.59218/makrjms.2023.751.756
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2023.751.756