Royal United Hospitals, Bath, UK.
J Hand Surg Eur Vol. 2023 Mar;48(3):230-245. doi: 10.1177/17531934221140238. Epub 2023 Jan 13.
The importance of distal radioulnar joint problems associated with distal radial fractures is recognized increasingly. But there remains considerable disagreement about how to treat these problems both acutely and chronically. This review outlines the knowledge about the natural history of ulnar-sided wrist problems with distal radials fractures. In particular, the recent increased understanding of the almost inevitable joint instability associated with distal radial fractures is highlighted, including the unreliability of clinical assessment and hence why there has been so much misunderstanding. Provided there is reasonable bony alignment, most ulnar-sided wrist problems can be treated non-operatively initially (typically for over a year) in anticipation of substantial improvement with time. The exception is early marked subluxation of the distal radioulnar joint (DRUJ) blocking forearm rotation, which needs urgent (typically closed) reduction.
与桡骨远端骨折相关的下尺桡关节问题的重要性日益被认识到。但对于这些问题的急性和慢性治疗，仍存在相当大的分歧。这篇综述概述了关于桡骨远端骨折伴尺侧腕部问题的自然病程的知识。特别是，最近对与桡骨远端骨折相关的几乎不可避免的关节不稳定的理解有所增加，包括临床评估的不可靠性，因此存在如此多的误解。如果有合理的骨对线，大多数尺侧腕部问题最初可以进行非手术治疗（通常持续一年以上），以期随着时间的推移有显著改善。例外的是早期明显的下尺桡关节（DRUJ）半脱位，阻碍前臂旋转，需要紧急（通常是闭合）复位。
