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Analyzing the reduction quality of the distal radioulnar joint after closed K-wire transfixation in a cadaver model: is supination or neutral position superior?
El Barbari, Jan Siad; Kohlhas, Laura; Franke, Jochen; Grützner, Paul Alfred; Schnetzke, Marc; Swartman, Benedict James.
Afiliación
  • El Barbari JS; BG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery, Clinic at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany.
  • Kohlhas L; Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany.
  • Franke J; BG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery, Clinic at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany.
  • Grützner PA; BG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery, Clinic at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany.
  • Schnetzke M; German Joint Center Heidelberg, ATOS Clinic Heidelberg, Heidelberg, Germany.
  • Swartman BJ; BG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery, Clinic at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany. benedict.swartman@bgu-ludwigshafen.de.
Arch Orthop Trauma Surg ; 144(4): 1603-1609, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38441618
ABSTRACT

INTRODUCTION:

Distal radioulnar joint (DRUJ) instabilities are challenging and their optimal treatment is controversial. In special cases or when reconstruction of the stabilizing triangular fibrocartilage complex (TFCC) fails, K-wire transfixation can be performed. However, no consensus has been reached regarding the rotational position of the forearm in which this should be done. Therefore, it was investigated whether anatomical reduction would best be achieved by transfixation in neutral position or supination of the forearm. MATERIALS AND

METHODS:

Twelve cadaveric upper limbs were examined before dissection of the DRUJ stabilizing ligaments and after closed transfixation in both positions by C-arm cone-beam CT. Whether this was first done in neutral position or in supination was randomized. The change in the radioulnar ratio (RR) in percentage points (%points) was analyzed using Student's t-test. RR was used since it is a common and sensitive method to evaluate DRUJ reduction, expressing the ulnar head's position in the sigmoid notch as a length ratio.

RESULTS:

The analysis showed an increased change in RR in neutral position with 5.4 ± 9.7%points compared to fixation in supination with 0.2 ± 16.1%points, yet this was not statistically significant (p = 0.404).

CONCLUSIONS:

Neither position leads to a superior reduction in general. However, the result was slightly closer to the anatomical position in supination. Thus, transfixation of the DRUJ should be performed in the position in which reduction could best be achieved and based on these data, that tends to be in supination. Further studies are necessary to validate these findings and to identify influential factors.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Antebrazo / Inestabilidad de la Articulación Límite: Humans Idioma: En Revista: Arch Orthop Trauma Surg Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Antebrazo / Inestabilidad de la Articulación Límite: Humans Idioma: En Revista: Arch Orthop Trauma Surg Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania