Injuries to the distal radioulnar joint.

Disorders of the distal radioulnar joint can be divided into those secondary to ligamentous injuries, fractures, and arthritis changes. Further classification of the first two categories relates to acute versus chronic problems. Acute radioulnar joint disruption can, for the most part, be diagnosed on the basis of early physical examination, radiographic evaluation, and a high index of suspicion. Early recognition and the institution of satisfactory treatment are the hallmarks of a successful result. Those injuries seen after 8 weeks can be termed chronic problems, and further diagnostic evaluation beyond physical examination and routine radiographs includes wrist arthrography, arthroscopy, tomograms, and CT scans. These disorders are certainly much more difficult to treat; however, a systematic assessment with a full knowledge of the anatomy and biomechanics is helpful in preventing arthritis as the late sequela of distal radioulnar joint abnormality. Surgical treatment may be necessary in many of these situations but must be tempered to the needs and demands of the individual patient.