Mulford Jonathan S, Axelrod Terry S
Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada M4N 3M5.
Hand Clin. 2010 Feb;26(1):155-63. doi: 10.1016/j.hcl.2009.08.015.
Traumatic injuries of the distal radioulnar joint (DRUJ) may give rise to complex wrist pathologies. Substantial ongoing disability can arise should these injuries go unrecognized resulting in sub-optimal treatment and lack of appropriate rehabilitation. Injuries of the DRUJ may occur in isolation but more commonly are found with a fracture of the radius. These challenging DRUJ injuries may be simple or complex (irreducible or severe instability), acute or chronic. An adequate knowledge of the stabilizers of the DRUJ is essential in understanding treatment options. Traumatic instability of the DRUJ is reviewed and the anatomy and stabilizing factors are discussed. An algorithm to guide selection of treatment options in complex cases is presented.
桡尺远侧关节(DRUJ)的创伤性损伤可能引发复杂的腕部病变。如果这些损伤未被识别,就会导致治疗不充分以及缺乏适当的康复,进而可能造成持续的严重残疾。DRUJ损伤可能单独发生,但更常见于伴有桡骨骨折的情况。这些具有挑战性的DRUJ损伤可能是简单的或复杂的(不可复位或严重不稳定),急性的或慢性的。充分了解DRUJ的稳定结构对于理解治疗方案至关重要。本文回顾了DRUJ的创伤性不稳定,并讨论了解剖结构和稳定因素。还提出了一种用于指导复杂病例治疗方案选择的算法。