title: Distal radio-ulnar joint instability in children and adolescents after wrist trauma.
abstract: This study retrospectively evaluated the medical records and radiographs of patients younger than aged 25 that were referred for a second opinion due to ulnar-sided wrist pain and persistent distal radio-ulnar (DRU) joint instability. We identified 85 patients with a major wrist trauma before the age of 18. Median age at trauma was 14 years. Median time between trauma and diagnosis of DRUJ instability was 3 years. Sixty-seven patients (79%) had sustained a fracture at the initial trauma. The two most common skeletal injuries related to the DRUJ instability were Salter-Harris type II fractures (24%) and distal radius fractures (19%). In 19 patients (22%), the secondary DRUJ instability was caused by malunion or growth arrest. Eighteen patients (21%) had no fracture; in spite of this, they presented with subsequent symptomatic DRUJ instability. Fourteen of these 18 patients had a triangular fibrocartilage complex (TFCC) tear, confirmed by arthroscopy, open surgery, or magnetic resonance imaging. In conclusion, late DRUJ instability due to wrist fractures or isolated TFCC tears was found to be common in children and adolescents.
  
  
  METHODS
  IV.
authors.affiliation: Department of Hand Surgery, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Sweden jonny.k.andersson@vgregion.se.
authors.forename: J K
authors.initials: JK
authors.lastname: Andersson
authors.affiliation: Pulvertaft Hand Centre, Kings Treatment Centre, Royal Derby Hospital, Derby, UK.
authors.forename: T
authors.initials: T
authors.lastname: Lindau
authors.affiliation: Department of Orthopaedics, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Karlsson
authors.affiliation: Department of Hand Surgery, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Fridén
mesh_terms: D000293:Adolescent; D002648:Child; D005543:Forearm Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D011885:Radius Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D051478:Triangular Fibrocartilage / Q000293:injuries / Q000601:surgery; D014458:Ulna Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D014954:Wrist Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery
keywords: Children; adolescents; distal radio-ulnar joint instability; triangular fibrocartilage complex tears; wrist trauma