What is DRUJ subluxation?
Isolated acute distal radioulnar joint (DRUJ) dislocation is a rare injury [1]. It is usually associated with fractures of either the radius or ulna. Sometimes it is part of a more complex injury like the Essex–Lopresti injury in which a fracture of the proximal radius and rupture of the interosseus membrane occurs.
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.
How do you treat a DRUJ injury?
Treatment include splinting, ORIF of fractures and repair of torn ligaments and TFCC by arthroscopy or open methods. In late presentations, instability is addressed by various techniques which have been described. DRUJ arthroplasty is emerging as a treatment in cases of arthrosis of the joint.
How do you fix a Subluxed wrist?
Non-surgical treatment of ECU subluxation consists of splinting or casting, as with other wrist tendon injuries, which will hold the joint in place and keep movement from exacerbating the problem and allowing the tendon to rest in its appropriate position while healing.
What is DRUJ disruption?
Dislocation of the distal radioulnar joint (DRUJ) is an extremely rare injury, particularly when it occurs without associated fractures of the distal radius and ulna.
Can a CT scan show druj subluxation and dislocation?
Wrist pain, plaster immobilization, or suboptimal wrist positioning may make it impossible to obtain a perfect lateral view of the wrist, thereby precluding the radiographic diagnosis of DRUJ subluxation and dislocation. In this instance, a single CT scan through the DRUJ is recommended.
How is a CT scan of the druj performed?
The CT scan was obtained through the DRUJ with the forearm in neutral rotation, active full supination and active full pronation. Three CT criteria were used to assess the DRUJ in all positions of unstable and normal wrists.
How reliable is CT in diagnosing distal radioulnar joint instability?
Objectives: The diagnosis of distal radioulnar joint (DRUJ) instability is clinically challenging. Computed tomography (CT) may aid in the diagnosis, but the reliability and normal variation for DRUJ translation on CT have not been established in detail.
How reliable is druj translation on CT of the wrist?
DRUJ translation on CT in pro- and supination can be reliably evaluated in both normal and posttraumatic wrists, however with large normal variation. The epicenter method seems the most reliable. Scanning of both wrists might be helpful to prevent the radiological overdiagnosis of instability.