Evidence map›Paper›PMID 38441618›Full record

ArticleArchives of orthopaedic and trauma surgery2024

Analyzing the reduction quality of the distal radioulnar joint after closed K-wire transfixation in a cadaver model: is supination or neutral position superior?

Jan Siad El Barbari, Laura Kohlhas, Jochen Franke, Paul Alfred Grützner, Marc Schnetzke, Benedict James Swartman

Abstract read
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Article in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Jan Siad El BarbariBG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery, Clinic at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany.
Laura KohlhasInstitute of Medical Biometry, University of Heidelberg, Heidelberg, Germany.
Jochen FrankeBG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery, Clinic at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany.
Paul Alfred GrütznerBG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery, Clinic at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany.
Marc SchnetzkeGerman Joint Center Heidelberg, ATOS Clinic Heidelberg, Heidelberg, Germany.
Benedict James SwartmanBG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery, Clinic at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany. benedict.swartman@bgu-ludwigshafen.de.ORCID http://orcid.org/0000-0003-4005-9923

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDistal radioulnar joint (DRUJ) instabilities are challenging and their optimal treatment is controversial. In special cases or when reconstruction of the stabilizing triangular fibrocartilage complex (TFCC) fails, K-wire transfixation can be performed. However, no consensus has been reached regarding the rotational position of the forearm in which this should be done. Therefore, it was investigated whether anatomical reduction would best be achieved by transfixation in neutral position or supination of the forearm. MATERIALS AND

methodsTwelve cadaveric upper limbs were examined before dissection of the DRUJ stabilizing ligaments and after closed transfixation in both positions by C-arm cone-beam CT. Whether this was first done in neutral position or in supination was randomized. The change in the radioulnar ratio (RR) in percentage points (%points) was analyzed using Student's t-test. RR was used since it is a common and sensitive method to evaluate DRUJ reduction, expressing the ulnar head's position in the sigmoid notch as a length ratio.

resultsThe analysis showed an increased change in RR in neutral position with 5.4 ± 9.7%points compared to fixation in supination with 0.2 ± 16.1%points, yet this was not statistically significant (p = 0.404).

conclusionsNeither position leads to a superior reduction in general. However, the result was slightly closer to the anatomical position in supination. Thus, transfixation of the DRUJ should be performed in the position in which reduction could best be achieved and based on these data, that tends to be in supination. Further studies are necessary to validate these findings and to identify influential factors.

Indexed as

ForearmJoint InstabilityBiomechanical PhenomenaCadaverHumansPronationSupinationWrist JointCadaveric studyDistal radioulnar joint instabilityDistal radius fractureK-wire transfixationRadioulnar ratio

Identifiers

PMID38441618
PMCPMC10965740

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