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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/2767

Title: Predictors of distal radioulnar joint instability in distal radius fractures.
Other Titles: 不安定型橈骨遠位端骨折に合併する橈尺靭帯損傷の予測因子
Authors: Fujitani, Ryotaro
Omokawa, Shohei
Akahane, Manabu
Iida, Akio
Ono, Hiroshi
Tanaka, Yasuhito
Keywords: Radioulnar
distal radius
Issue Date: Nov-2011
Publisher: American Society for Surgery of the Hand / Elsevier
Citation: The Journal of hand surgery Vol.36 No.12 p.1919-1925
Abstract: PURPOSE:A tear of the triangular fibrocartilage complex (TFCC) is the most frequent soft tissue injury associated with fractures of the distal radius, and repair of the deep ligamentous portion of the TFCC is considered when the tear contributes to instability of the distal radioulnar joint (DRUJ). The purpose of this prospective cohort study was to identify predictors of DRUJ instability accompanying unstable distal radius fractures. METHODS:Between 2002 and 2007, we prospectively treated 163 consecutive patients with unstable distal radius fractures with the volar locking plating system. Complete radioulnar ligament tears representing DRUJ instability were present in 11 of 163 distal radius fractures. We tested univariate associations between DRUJ instability and potential predictors and conducted multivariate analysis to establish independent predictors of instability. We applied receiver operating characteristics curves within the significant risk factors to determine threshold values. RESULTS:In univariate analyses, only the radial and sagittal translation ratios of the fracture site were significant predictors of DRUJ instability. Multivariate logistic regression analysis confirmed that the radial translation ratio, which corresponds to a normalized DRUJ gap, was a significant risk factor. According to the receiver operating characteristics curve for the radial translation ratio, the area under the curve was 0.89. A cutoff value of 15% for the radial translation ratio showed the highest diagnostic accuracy rate. CONCLUSIONS:A radiographic finding of a normalized DRUJ gap on posteroanterior views was the most important predictor to identify DRUJ instability accompanying unstable distal radius fractures. The relative risk of instability increases by 50% when the ratio of DRUJ widening increases by 1%.
Description: 博士(医学)・乙第1295号・平成24年5月28日
Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved
URI: http://hdl.handle.net/10564/2767
ISSN: 03635023
Appears in Collections:2012年度

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