Predictive factors of distal radioulnar joint instability after surgical treatment of distal radius fractures

Abstract

Abstract Background: Distal radioulnar joint (DRUJ) instability is a common postoperative complication of distal radius fractures (DRFs), seriously impacting patients' quality of life. This study investigated its possible influencing factors to determine prognosis and to guide treatment better. Methods: We retrospectively included a series of patients with DRFs that underwent volar locking plate (VLP) fixation. Basic patient information and imaging parameters were collected. The incidence of DRUJ instability during follow-up was recorded, and factors associated with DRUJ instability were determined using univariate analysis and multifactorial logistic regression analysis. Results: A total of 116 patients were enrolled in this study. At 6 months of follow-up, 37 patients (31.9%) had DRUJ instability, and multivariate analysis showed coronal plane displacement (OR,2.419; 95% CI,1.083-5.402), fracture classification (OR,0.393; 95% CI,0.172-0.900) and DRUJ interval (OR,3.008; 95% CI,1.341-6.748) were associated with DRUJ instability after VLP. Conclusions: DRUJ interval, coronal plane displacement, and fracture classification are associated with DRUJ instability during follow-up. Therefore, preoperative risk communication and intraoperative attention to recovering relevant imaging parameters are necessary for these patients.