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Nonsurgical Treatment for Acute Posttraumatic Distal Radioulnar Joint Instability: A Case Series
Bachinskas, Andrew J. Helsper, Elizabeth A. Morris, Harry A. Hearon, Bernard F.
Bachinskas, Andrew J.
Helsper, Elizabeth A.
Morris, Harry A.
Hearon, Bernard F.
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Abstract
Purpose
We investigated the clinical outcomes of patients with acute posttraumatic distal radioulnar joint (DRUJ) instability who were treated with our nonsurgical protocol.
Methods
The electronic database of our community-based orthopedic practice was queried to identify patients with posttraumatic wrist pain and DRUJ instability who presented for treatment less than 6 weeks after injury. Medical records review defined a cohort of 16 patients treated between November, 2000 and December, 2016 with immobilization of the wrist and elbow for 6 weeks and gradual return to full activity at 6 months after injury. Data from the medical records were compiled and analyzed to assess short-term outcomes. Eight patients with a minimum 2-year follow-up completed questionnaires and underwent a wrist-focused examination to assess long-term outcomes. We used Wilcoxon signed-ranks exact test and McNemar chi-square exact test to confirm the statistical significance of observed trends in key outcome measures.
Results
At a mean long-term follow-up of 6.7 years, there was statistically significant improvement in ulnar-sided wrist pain and all eight subjects examined demonstrated a negative dorsopalmar stress test indicating improved DRUJ stability. Analysis of the entire cohort showed that 11 of 16 patients (69%) were overall improved with respect to wrist pain and DRUJ stability at final follow-up evaluation. Ulnar-positive variance was a relative contraindication to nonsurgical treatment.
Conclusions
Prompt above-elbow immobilization of patients with acute posttraumatic DRUJ instability may result in a good clinical outcome without operative treatment.
Description
A grant from the One-University Open Access Fund at the University of Kansas was used to defray the author's publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml.
Date
2019-12-03
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Elsevier
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Keywords
Distal radioulnar joint instability, Nonsurgical treatment, Ulnar-sided wrist pain, Wrist sprain