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Distal Radioulnar Joint Dislocation

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Other Names

  • DRUJ Injury
  • Distal Radioulnar Joint Disruption
  • Distal Radioulnar Joint Instability
  • Distal Radioulnar Joint Subluxation
  • DRUJ Disruption
  • DRUJ Instability
  • DRUJ Subluxation

Background


Pathophysiology


Risk Factors

  • Unknown

Differential Diagnosis

Differential Diagnosis Wrist Pain

Differential Diagnosis Forearm Pain


Clinical Features

  • General: Physical Exam Wrist
  • Acute
    • Patient has swelling, deformity
    • Inability to supinate/pronate the forearm
  • Subacute/ Chronic
    • Snapping, crepitus
    • Decreased grup strength
  • DRUJ Compression Test: Exacerbating symptoms with compression
  • Piano Key Test: Pain with manipulation of distal ulna

Evaluation

Radiographs

  • Standard Radiographs Wrist
  • Typically sufficient to make diagnosis
  • AP view: widening of DRUJ
  • Lateral view: dorsal displacement (most commonly)
  • Description of ulnar in reference to the radius

CT

  • Can be performed dynamically for subtle DRUJ injuries

MRI

  • Evaluate for other soft tissue injuries

Classification

  • NA

Management

Nonoperative

  • Nonsurgical management indicated in some cases
  • Indications
    • Isolated ligamentous injury without fracture
    • TFCC Tear (acute)
  • Closed reduction
  • Cast: Short Arm Cast for 4-6 weeks

Operative

  • Indications:
    • Ulnar styloid fracture displaced with instability
    • Essex-Lopresti Fracture
    • Galeazzi Fracture

Return to Play

  • Highly variable depending on injury pattern
  • In general, minimum 6 weeks and will require post-recovery rehab

Complications

  • DRUJ Arthritis

See Also


References


  1. Mirghasemi AR, Lee DJ, Rahimi N, Rashidinia S, Elfar JC. Distal Radioulnar Joint Instability. Geriatr Orthop Surg Rehabil. 2015 Sep;6(3):225-9.
Created by:
John Kiel on 18 June 2019 23:03:09
Authors:
Last edited:
27 October 2020 23:04:28
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