title: The effect of acute distal radioulnar joint laxity on outcome after volar plate fixation of distal radius fractures.
abstract: OBJECTIVE
  The objective of this study was to determine whether intraoperative laxity of the distal radioulnar joint (DRUJ) is associated with adverse postoperative outcomes after volar plate fixation of a distal radius fracture (DRF) and 4 weeks of immobilization.
  
  
  METHODS
  Prospective study with clinical and radiographic assessment.
  
  
  METHODS
  Level 1 trauma center.
  
  
  METHODS
  One hundred consecutive patients were treated by volar locking plate fixation at our institution for an unstable DRF from April 2007 to November 2009. Of these patients, 84 patients with a minimum follow-up of 12 months were enrolled in this study.
  
  
  METHODS
  Intraoperative DRUJ laxity was evaluated using a radioulnar stress test after fixation of DRF using volar locking plate and splint immobilization of the forearm for 1 month in patients with intraoperative DRUJ laxity. Patients were allocated to an unstable group or stable group according to the presence of intraoperative DRUJ laxity.
  
  
  METHODS
  Our primary outcome measure was disabilities of arm, shoulder, and hand score and the secondary outcome measures were wrist motion, grip strength, modified Mayo wrist score, visual analogue scale for wrist pain, and ongoing pain in the DRUJ.
  
  
  RESULTS
  Nineteen of the 84 study subjects were allocated to the unstable group and 65 to the stable group. No significant differences were observed between 2 groups in wrist range of motion, grip strength, modified Mayo wrist score, disabilities of arm, shoulder, and hand score, visual analogue scale score, and ongoing pain in the DRUJ at 1 year postoperatively.
  
  
  CONCLUSIONS
  In our series of patients treated with volar locking plate and immobilization of the forearm for 1 month in patients with intraoperative laxity of the DRUJ, laxity did not affect impairment, pain, or disability 1 year after fracture. However, the role of postoperative immobilization of the forearm is debatable and merits additional study.
  
  
  METHODS
  Prognostic level I.
authors: Department of Orthopedic Surgery, School of Medicine, Ewha Womans University, Seoul, Korea.
authors: Jae K
authors: JK
authors: Kim
authors: Ju W
authors: JW
authors: Yi
authors: Sang H
authors: SH
authors: Jeon
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000706:statistics & numerical data; D017102:Fracture Healing; D006225:Hand / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D015994:Incidence; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D055815:Young Adult