What is a DRUJ injury?

DRUJ injuries The injuries of the DRUJ may involve purely soft tissues or fractures of the radius and/or ulnar styloid or, more rarely, isolated dislocations of the joint.

How do you evaluate a DRUJ?

Evaluation of the DRUJ begins with palpation over the distal radius and lunate articulation that proceeds ulnarly to the sigmoid notch and distal ulna. Pain that occurs with forearm pronation and supination may suggest DRUJ disease. The examiner must be careful to rotate the forearm at the wrist, not at the hand.

How do I check my DRUJ instability?

Different physical tests for the diagnosis of DRUJ instability have been described, including the Ballottement test, radius pull test, clunk test, extensor carpi ulnaris (ECU) test, and press test. The Ballottement test is considered the most reliable physical examination test for DRUJ instability.

What is DRUJ subluxation?

Abstract. Subluxation of the distal radioulnar joint (DRUJ) is associated with extensor tendon rupture in patients with rheumatoid arthritis (RA). However, it remains difficult to quantitatively evaluate DRUJ subluxation in RA wrist. We devised a new method for assessing DRUJ subluxation.

What causes DRUJ instability?

Distal Radioulnar Joint Instability occurs when articular contact between the two forearm bones at the wrist follows an abnormal path in rotation. Though this is an exceptionally stable and mobile joint, it is prone to injury when someone falls on an outstretched hand (FOOSH) with the wrist pronated.

What is DRUJ replacement?

A DRUJ implant replacing the ulnar head should and has to be the fixed point and load-bearing part of the joint and will be exerted to large mechanical loads making a neutralization of these forces necessary. A partial resurfacing implant for the DRUJ can be used for primary procedures.

How do you stabilize DRUJ?

Method 1. The elbow is flexed 90° on the arm table and displacement in dorsal palmar direction is tested in a neutral rotation of the forearm with the wrist in neutral position. This is repeated with the wrist in radial deviation, which stabilizes the DRUJ, if the ulnar collateral complex (TFCC) is not disrupted.

What is distal radius?

The radius is one of two forearm bones and is located on the thumb side. The part of the radius connected to the wrist joint is called the distal radius. When the radius breaks near the wrist, it is called a distal radius fracture.

What is a radial head replacement?

Radial head replacement surgery is undertaken on a patient’s elbow following a complex fracture to the radial head where fixation by means other than with screws or a plate is not suitable or feasible. During surgery, the fractured bone and joint surface of the radius is removed and replaced with an artificial implant.

What is darrach resection?

Darrach’s procedure or distal ulna resection is a surgical technique for the surgical removal of the head of ulna. It is performed in cases of radial–ulnar joint pain and instability. The styloid process and muscular attachments are left intact.

How do you prevent a DRUJ dislocation?

For most simple cases, anterior DRUJ dislocation can be treated successfully with closed reduction, followed by an above-elbow cast for a duration of three to six weeks [2, 14, 15, 18, 22, 25, 26].

Why is DRUJ most stable in supination?

In pronation, the superficial dorsal and deep palmer fibers tighten to keep the DRUJ stable. In supination, the superficial palmer fibers and the deep dorsal fibers both tighten to provide stability.