Application of Suspension Fixation with Button Plates for Patients with Distal Radioulnar Joint Dislocation: A Case Series.

ABSTRACT

OBJECTIVE: The aim of the present study was to assess the effect of suspension fixation with button plates on the reconstruction of the distal radioulnar joint dislocation (DRUJ). METHODS: This was a case series of six patients (two men and four women) who underwent suspension fixation with button plates for DRUJ dislocation between January 2015 and May 2017. Physical examination, radiography, MRI, functional activity of the wrist joint, grip strength of the wrist joint, Garland-Werley wrist score, Mayo wrist score, and visual analog scale (VAS) score were used to evaluate the effect of this procedure. All patients were followed up every 3 months. The evaluation time point was 12 months after the operation. Comparisons of the functional indexes of wrist function before and after the operation were performed using paired statistical tests. RESULTS: The mean range of motion of the affected limb was 70° at forearm pronation and 75° at forearm supination. The subjective assessments and tests of the motor function of the wrist showed improvement after surgery. The Garland-Werley wrist score was 13.50 ± 2.66 preoperatively, the Mayo wrist score was 56.67 ± 18.35, and the VAS score was 4.83 ± 1.17. The Garland-Werley wrist score was 2.83 ± 1.33 postoperatively at 12 months, the Mayo wrist score was 87.5 ± 6.89, and the VAS score was 0.50 ± 0.55. At 12 months, the Garland-Werley wrist score, the Mayo wrist score, and the VAS score showed significant improvements when compared with those before surgery (P = 0.000, P = 0.003, and P = 0.000, respectively). Radiographic examination revealed that the internal fixation device was in place, and no dislocation of the DRUJ could be observed. None of the patients had internal fixation device removal or re-dislocation of the DRUJ. None of the patients had re-dislocation of the DRUJ. No secondary ulnar or radial fractures and nerve injury were reported during and after surgery. No tumor recurrence was observed in patients with giant cell tumors of the tendon sheath. No loosening and displacement of screws were reported. CONCLUSION: The new method of suspension fixation with button plates for the surgical reconstruction of a DRUJ dislocation is simple, with minimal trauma, and maintains the stability of the DRUJ without the need for intra-articular or extra-articular reconstruction of the ligament. Furthermore, it allows early functional exercise and achieves satisfactory postoperative functional recovery.