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Subject Area

Orthopedics

Article Type

Original Study

Abstract

Objectives: to evaluate the clinical and functional outcomes after ulnar shortening osteotomy and open the triangular fibrocartilage complex (TFCC) repair in posttraumatic malunited distal radius with ulna plus deformity. Background: Distal radio-ulnar joint (DRUJ) stability depends on both bony structure configuration (20%) and soft tissues integrity (80%) including the TFCC, pronator quadratus, and interosseous membrane. One of the commonest etiologies for acquired DRUJ instability is malunited distal radius fractures with radial shortening, acquired ulna plus deformity and TFCC tear or insufficiency. Methods: a prospective case series of patients with DRUJ instability and ulna plus deformity after malunited distal radius fracture. They were surgically managed by ulnar shortening osteotomy and open TFCC repair. Mayo wrist score was used for clinical evaluation. Postoperative radiological evaluation was assessed by achievement of radiological union at the osteotomy site and restoration of neutral ulnar variance. Postoperative complications were reported. Results: This study included 20 patients (20 wrists), 11 (55%) females and 9 (45%) males with a mean age of 35.8±8.81(18-46) years. There was a highly statistically significant improvement in the mean Mayo wrist score from 53.25±18.83 preoperatively to 86.75±18.08 points, P < 0.001 at 6 months of follow‑up. There were excellent results in 14 patients (70%), good results in one patient (5%), Fair results in 4 patients (20%) and poor results in one patient (5%). Conclusions: Ulnar shortening osteotomy combined with open TFCC repair achieved satisfactory clinical and radiological outcomes in the treatment of DRUJ instability with ulna plus deformity after malunited distal radius fractures.

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