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This review outlines the knowledge about the natural history of ulnar-sided wrist problems with distal radials fractures. In particular, the recent increased understanding of the almost inevitable joint instability associated with distal radial fractures is highlighted, including the unreliability of clinical assessment and hence why there has been so much misunderstanding. Provided there is reasonable bony alignment, most ulnar-sided wrist problems can be treated non-operatively initially (typically for over a year) in anticipation of substantial improvement with time. The exception is early marked subluxation of the distal radioulnar joint (DRUJ) blocking forearm rotation, which needs urgent (typically closed) reduction.<\/jats:p>","DOI":"10.1177\/17531934221140238","type":"journal-article","created":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T13:36:18Z","timestamp":1673616978000},"page":"230-245","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["The distal radioulnar joint after distal radial fractures: when and how do we need to treat pain, stiffness or instability?"],"prefix":"10.1177","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4817-853X","authenticated-orcid":false,"given":"Grey","family":"Giddins","sequence":"first","affiliation":[{"name":"Royal United Hospitals, Bath, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,1,13]]},"reference":[{"key":"bibr1-17531934221140238","unstructured":"AAOS (American Academy of Orthopaedic Surgeons). 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