Forearm and Elbow Conditions

Nerve / Tendon:
Carpal Instability
Distal Radio Ulnar Joint (DRUJ) Injury
Triangular Fibrocartilage Complex (TFCC) Tears
Wrist Sprain


Distal Radio Ulnar Joint (DRUJ) Injury

A distal radioulnar joint (DRUJ) injury may be the result of ligamentous disruption or fracture, which compromises joint stability.

A DRUJ injury can occur separately or in conjunction with distal radius fractures and both-bone forearm fractures. In fact, nearly 60 percent of forearm fractures negatively impact the DRUJ.

The radius rotates around the ulna, a stable and stationary anatomical point of reference for rotation for the forearm. While the distal and proximal radioulnar joints form the forearm joint, mobility and stability of the distal radioulnar joint is accomplished only with fully congruent articulating surfaces and radioulnar ligaments that are strong and secured.

Risk Factors
Those involved in activities or sports that put the forearm at risk of strong force or impact or those suffering from osteoarthritis or rheumatoid arthritis are likely to suffer from DRUJ pain or instability.

Diagnosis and Treatment
Following a thorough review of patient history and a physical examination, a radiograph and possible CT scan can further identify the extent of the damage and area of instability. Accurate assessment of DRUJ stability, particularly when late instability is suspected after the associated fractures have healed, requires a detailed assessment.

Exploratory arthroscopy may be used to help identify stable and partially unstable lesions.

If a DRUJ injury occurred as the result of a fracture, the associated fracture is first addressed. Depending on the level of joint instability, additional fixation of the joint may also be required.