Ichikawa Takeru, Suzuki Taku, Kimura Hiroo, Matsumura Noboru, Iwamoto Takuji, Nakamura Masaya, Matsumoto Morio
Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
J Wrist Surg. 2022 Jan 20;12(3):269-272. doi: 10.1055/s-0041-1742202. eCollection 2023 Jun.
Locking of the distal radioulnar joint (DRUJ) induces restriction of the active and passive motion of pronation or supination of the forearm. Diagnosis of DRUJ locking due to a triangular fibrocartilage complex (TFCC) tear is sometimes difficult. A 15-year-old female suffered from restriction of forearm supination after cast immobilization for the treatment of an elbow injury. The active and passive range of motion (ROM) of supination was 30 degrees, while the active ROM of pronation was normal. Radiographs of the elbow showed a fracture of the medial epicondyle and a fracture around the radial head. Radiographs of the wrist showed a subluxation of the ulnar head. Accurate diagnosis of supination restriction was difficult before surgery, so an operation was performed for the diagnosis and treatment. DRUJ locking was reduced manually and arthroscopic findings showed central perforation of the TFCC. Forearm supination improved to 90 degrees postoperatively. DRUJ locking due to a TFCC injury is rare and this condition with bipolar injury has not been reported. DRUJ locking due to an injured TFCC should be considered as one of the differential diagnoses of supination contracture.
桡尺远侧关节（DRUJ）锁定会导致前臂旋前或旋后主动和被动活动受限。因三角纤维软骨复合体（TFCC）撕裂导致的DRUJ锁定的诊断有时较为困难。
一名15岁女性在因肘部损伤接受石膏固定治疗后出现前臂旋后受限。旋后的主动和被动活动范围（ROM）为30度，而旋前的主动ROM正常。肘部X线片显示内侧髁骨折和桡骨头周围骨折。腕部X线片显示尺骨头半脱位。术前难以准确诊断旋后受限，因此进行了手术以明确诊断并进行治疗。手动复位DRUJ锁定，关节镜检查发现TFCC中央穿孔。术后前臂旋后改善至90度。
因TFCC损伤导致的DRUJ锁定较为罕见，这种双极损伤的情况尚未见报道。
因TFCC损伤导致的DRUJ锁定应被视为旋后挛缩的鉴别诊断之一。
