• Richelle Takemoto, Michelle Sugi, Igor Immerman, Nirmal Tejwani, and Kenneth A Egol.
• NYU Hospital for Joint Diseases, 301 East 17th Street Suite 1402, New York, NY, 10003, USA.
• J Orthop Traumatol. 2014 Mar 1; 15 (1): 41-6.

BackgroundWe investigated the radiographic parameters that may predict distal radial ulnar joint (DRUJ) instability in surgically treated radial shaft fractures. In our clinical experience, there are no previously reported radiographic parameters that are universally predictive of DRUJ instability following radial shaft fracture.Materials And MethodsFifty consecutive patients, ages 20-79 years, with unilateral radial shaft fractures and possible associated DRUJ injury were retrospectively identified over a 5-year period. Distance from radial carpal joint (RCJ) to fracture proportional to radial shaft length, ulnar variance, and ulnar styloid fractures were correlated with DRUJ instability after surgical treatment.ResultsTwenty patients had persistent DRUJ incongruence/instability following fracture fixation. As a proportion of radial length, the distance from the RCJ to the fracture line did not significantly differ between those with persistent DRUJ instability and those without (p = 0.34). The average initial ulnar variance was 5.5 mm (range 2-12 mm, SD = 3.2) in patients with DRUJ instability and 3.8 mm (range 0-11 mm, SD = 3.5) in patients without. Only 4/20 patients (20%) with DRUJ instability had normal ulnar variance (-2 to +2 mm) versus 15/30 (50%) patients without (p = 0.041).ConclusionIn the setting of a radial shaft fracture, ulnar variance greater or less than 2 mm was associated with a greater likelihood of DRUJ incongruence/instability following fracture fixation.

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