Effects of distal radius malunion on distal radioulnar joint mechanics—an in vivo study

✍ Scribed by Joseph J. Crisco; Douglas C. Moore; G. Elisabeta Marai; David H. Laidlaw; Edward Akelman; Arnold-Peter C. Weiss; Scott W. Wolfe

• Publisher: Elsevier Science
• Year: 2007
• Tongue: English
• Weight: 202 KB
• Volume: 25
• Category: Article
• ISSN: 0736-0266
• DOI: 10.1002/jor.20322

✦ Synopsis

Abstract

Patients with a malunited distal radius often have painful and limited forearm rotation, and may progress to arthritis of the distal radioulnar joint (DRUJ). The purpose of this study was to determine if DRUJ congruency and mechanics were altered in patients with malunited distal radius fractures. In nine subjects with unilateral malunions, interbone distances and dorsal and palmar radioulnar ligament lengths were computed from tomographic images of both forearms in multiple forearm positions using markerless bone registration (MBR) techniques. The significance of the changes were assessed using a generalized linear model, which controlled for forearm rotation angle (−60° to 60°). In the malunited forearm, compared to the contralateral uninjured arm, we found that ulnar joint space area significantly decreased by approximately 25%, the centroid of this area moved an average of 1.3 mm proximally, and the dorsal radioulnar ligament elongated. Despite our previous findings of insignificant changes in the pattern of radioulnar kinematics in patients with malunited fractures, we found significant changes in DRUJ joint area and ligament lengthening. These findings suggest that alterations in joint mechanics and soft tissues may play an important role in the dysfunction associated with these injuries. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:547–555, 2007