Evaluation of distal radioulnar joint fixation using a fixation button in galeazzi fracture dislocations: Radiological and functional outcomes

Background: A Galeazzi fracture, characterized by a distal radial diaphyseal fracture and distal radioulnar joint (DRUJ) instability, is diagnosed via X-ray. Following surgical fixation of the radius, DRUJ stability has to be assessed. Unstable DRUJ necessitates surgical intervention, while stable D...

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Main Authors: Ashish Kumar Shukla, Anil Kumar Mishra, Ashish Pande, Aditya Dwivedi
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Journal of Orthopaedic Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2773157X24002212
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author Ashish Kumar Shukla
Anil Kumar Mishra
Ashish Pande
Aditya Dwivedi
author_facet Ashish Kumar Shukla
Anil Kumar Mishra
Ashish Pande
Aditya Dwivedi
author_sort Ashish Kumar Shukla
collection DOAJ
description Background: A Galeazzi fracture, characterized by a distal radial diaphyseal fracture and distal radioulnar joint (DRUJ) instability, is diagnosed via X-ray. Following surgical fixation of the radius, DRUJ stability has to be assessed. Unstable DRUJ necessitates surgical intervention, while stable DRUJ is managed with cast immobilization. Aim: This study aimed to introduce a novel surgical technique for the fixation of unstable DRUJ with an ONButton™ that promotes early mobilization and stability of DRUJ in Galeazzi fracture-dislocation and evaluate the radiological and functional outcome in 15 patients who visited the Tertiary Care Centre, Base Hospital, Lucknow. Method: A total of 15 patients diagnosed with Galeazzi fractures were enrolled in this investigation and treated at our center from June 2019 to May 2020. A single surgical team performed all patients' surgeries within seven days of injury. DRUJ stability was assessed preoperatively. Unstable fractures were percutaneously fixated using an ONButton™ with fiber wire under fluoroscopic guidance using a beath pin. Subsequently, the diaphyseal radial fracture was fixated with a compression plate (LCDCP/DCP). Following fixation, DRUJ stability was re-evaluated using the piano key test with volar, dorsal, and neutral rotational stress applied to the DRUJ in supination, protonation, and neutral forearm positions. Results: Fifteen patients (12 males, 3 females) with stable DRUJ confirmed by radiograph at 6, 12, and 24 weeks post-surgery were followed up for 6 months. At 6 months, 12 patients achieved excellent results, and 2 patients showed good results. Range of motion, Mikic clinical outcome score, and Mayo modified write score were used to evaluate the functional outcomes. Three patients had terminal supination restriction, and five had terminal protonation restriction, but no significant limitations in the overall range of motion were observed. Conclusion: Percutaneous ONButton™ fixation for DRUJ fractures demonstrates promise as a surgical intervention, achieving high patient satisfaction.
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spelling doaj-art-59ac69caaabf4597b8f01677527a3be42025-08-20T03:31:24ZengElsevierJournal of Orthopaedic Reports2773-157X2025-04-014110052610.1016/j.jorep.2024.100526Evaluation of distal radioulnar joint fixation using a fixation button in galeazzi fracture dislocations: Radiological and functional outcomesAshish Kumar Shukla0Anil Kumar Mishra1Ashish Pande2Aditya Dwivedi3Corresponding author.; Department of Orthopedics, Command Hospital, Lucknow Cantt, UP, 226002, IndiaDepartment of Orthopedics, Command Hospital, Lucknow Cantt, UP, 226002, IndiaDepartment of Orthopedics, Command Hospital, Lucknow Cantt, UP, 226002, IndiaDepartment of Orthopedics, Command Hospital, Lucknow Cantt, UP, 226002, IndiaBackground: A Galeazzi fracture, characterized by a distal radial diaphyseal fracture and distal radioulnar joint (DRUJ) instability, is diagnosed via X-ray. Following surgical fixation of the radius, DRUJ stability has to be assessed. Unstable DRUJ necessitates surgical intervention, while stable DRUJ is managed with cast immobilization. Aim: This study aimed to introduce a novel surgical technique for the fixation of unstable DRUJ with an ONButton™ that promotes early mobilization and stability of DRUJ in Galeazzi fracture-dislocation and evaluate the radiological and functional outcome in 15 patients who visited the Tertiary Care Centre, Base Hospital, Lucknow. Method: A total of 15 patients diagnosed with Galeazzi fractures were enrolled in this investigation and treated at our center from June 2019 to May 2020. A single surgical team performed all patients' surgeries within seven days of injury. DRUJ stability was assessed preoperatively. Unstable fractures were percutaneously fixated using an ONButton™ with fiber wire under fluoroscopic guidance using a beath pin. Subsequently, the diaphyseal radial fracture was fixated with a compression plate (LCDCP/DCP). Following fixation, DRUJ stability was re-evaluated using the piano key test with volar, dorsal, and neutral rotational stress applied to the DRUJ in supination, protonation, and neutral forearm positions. Results: Fifteen patients (12 males, 3 females) with stable DRUJ confirmed by radiograph at 6, 12, and 24 weeks post-surgery were followed up for 6 months. At 6 months, 12 patients achieved excellent results, and 2 patients showed good results. Range of motion, Mikic clinical outcome score, and Mayo modified write score were used to evaluate the functional outcomes. Three patients had terminal supination restriction, and five had terminal protonation restriction, but no significant limitations in the overall range of motion were observed. Conclusion: Percutaneous ONButton™ fixation for DRUJ fractures demonstrates promise as a surgical intervention, achieving high patient satisfaction.http://www.sciencedirect.com/science/article/pii/S2773157X24002212DislocationDistal radioulnar jointFixation buttonGaleazzi fracture
spellingShingle Ashish Kumar Shukla
Anil Kumar Mishra
Ashish Pande
Aditya Dwivedi
Evaluation of distal radioulnar joint fixation using a fixation button in galeazzi fracture dislocations: Radiological and functional outcomes
Journal of Orthopaedic Reports
Dislocation
Distal radioulnar joint
Fixation button
Galeazzi fracture
title Evaluation of distal radioulnar joint fixation using a fixation button in galeazzi fracture dislocations: Radiological and functional outcomes
title_full Evaluation of distal radioulnar joint fixation using a fixation button in galeazzi fracture dislocations: Radiological and functional outcomes
title_fullStr Evaluation of distal radioulnar joint fixation using a fixation button in galeazzi fracture dislocations: Radiological and functional outcomes
title_full_unstemmed Evaluation of distal radioulnar joint fixation using a fixation button in galeazzi fracture dislocations: Radiological and functional outcomes
title_short Evaluation of distal radioulnar joint fixation using a fixation button in galeazzi fracture dislocations: Radiological and functional outcomes
title_sort evaluation of distal radioulnar joint fixation using a fixation button in galeazzi fracture dislocations radiological and functional outcomes
topic Dislocation
Distal radioulnar joint
Fixation button
Galeazzi fracture
url http://www.sciencedirect.com/science/article/pii/S2773157X24002212
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AT ashishpande evaluationofdistalradioulnarjointfixationusingafixationbuttoningaleazzifracturedislocationsradiologicalandfunctionaloutcomes
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