{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T15:11:52Z","timestamp":1778080312916,"version":"3.51.4"},"reference-count":23,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPHS"],"abstract":"<jats:p>Purpose: This study aimed to (1) introduce a simple and reproducible method to assess severe radial translation of distal radius fractures (DRF) which is a potential cause of distal radioulnar joint (DRUJ) instability, and (2) to construct a treatment-oriented classification.\nMaterials and methods: From 2018 to 2023, stress test (ballottement test) was performed to detect DRUJ instability associated with DRF after treatment with locking plate fixation. Potential radiographic predictors of DRUJ instability focus on radial translation were accessed. The severity of radial translation was described by a readily and easily technique as \u2018point- baseline\u2019 method. According to this method, radial translation was categorized into three grades: no translation (the marking points not moved), moderate translation (the marking points moved, but were located on the ulnar side of the baseline), and severe translation (the marking points moved and reached the baseline position, or even completely moved to the radial side of the baseline). All these fractures were divided into two groups, namely Group A (cases with no translation or moderate translation) and Group B (cases with severe translation). Relationships between DRUJ instability and the radiographic parameter of radial translation were analyzed. To investigate the causes of DRUJ instability, all of the cases with DRUJ instability were further divided into two subgroups: subgroup A (cases with DRUJ instability in Group A) and subgroup B (cases with DRUJ instability in Group B). Practices to address DRUJ instability at the time of DRF fixation were explored.\nResults: There were 226 patients enrolled in this study. According to \u2018point- baseline\u2019 method, there were 174 wrists in Group A and 52 wrists in Group B. There were 34 cases (19.54%) diagnosed as having DRUJ instability intraoperatively via manual stress testing in Group A, while 36 cases (69.23%) in Group B. There was significant difference in the incidence of DRUJ instability between the two groups (p &lt; 0.0001). Of the 70 cases with DRUJ instability, 18 cases regained stability by ulnar styloid fracture fixation, 12 cases by dorsal ulnar corner fragment (sigmoid notch fracture) fixation, and 40 cases by arthroscopy-assisted triangular fibrocartilage complex (TFCC) repair. To investigate the causes of DRUJ instability, there were 34 wrists in subgroup A, while 36 wrists in subgroup B. There were no significant differences between the two subgroups regarding the causes of DRUJ instability including ulnar styloid process fracture, dorsal ulnar corner fragment (sigmoid notch fracture), and traumatic TFCC injury.\nConclusions: This study helped establish a \u2018point- baseline\u2019 method which can be readily and easily used to identify the severity of radial translation, which was a significant predictor of DRUJ instability. On the other hand, whether or not severe radial translation, treatment of DRUJ instability by the three major ways: (1) the ulnar styloid fracture fixation; (2) the dorsal ulnar corner fragment fixation; and (3) traumatic TFCC injuries repairing.<\/jats:p>","DOI":"10.2340\/jphs.v61.46005","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T14:24:00Z","timestamp":1778077440000},"page":"104-109","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of severe radial translation of distal radius fractures which is a potential cause of distal radioulnar joint instability"],"prefix":"10.2340","volume":"61","author":[{"given":"Jiang","family":"Huajun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liu","family":"Sida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiang","family":"Peilong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhang","family":"Borui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Jingjing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qu","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"154510","doi-asserted-by":"crossref","unstructured":"Bombaci H, Polat A, Deniz G, et al. The value of plain X-rays in predicting TFCC injury after distal radial fractures. J Hand Surg Eur Vol. 2008;33(3):322\u2013326.","DOI":"10.1177\/1753193408090106"},{"key":"154511","doi-asserted-by":"crossref","unstructured":"Hagert E, Hagert CG. Understanding stability of the distal radioulnar joint hrough an understanding of its anatomy. Hand Clin. 2010;26(4):459\u2013466.","DOI":"10.1016\/j.hcl.2010.05.002"},{"key":"154512","doi-asserted-by":"crossref","unstructured":"Pajares S, Martinez-Catalan N, Novo-Rivas U. Stabilization for acute distal adioulnar nstability: a novel surgical technique. Injury. 2021;52(Suppl 4):S137\u2013S144.","DOI":"10.1016\/j.injury.2021.02.043"},{"key":"154513","doi-asserted-by":"crossref","unstructured":"Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular ibrocartilage complex cause distal radioulnar joint instability after distal radial ractures. J Hand Surg Am. 2000;25(3):464\u2013468.","DOI":"10.1053\/jhsu.2000.6467"},{"key":"154514","doi-asserted-by":"crossref","unstructured":"Lindau T, Hagberg L, Adlercreutz C, et al. Distal radioulnar instability is an ndependent worsening factor in distal radial fractures. Clin Orthop Relat Res. 2000;376(376):229\u2013235.","DOI":"10.1097\/00003086-200007000-00031"},{"key":"154515","doi-asserted-by":"crossref","unstructured":"Qazi S, Graham D, Regal S, et al. Distal radioulnar joint instability and associated njuries: a literature review. J Hand Microsurg. 2021;13(3):123\u2013131.","DOI":"10.1055\/s-0041-1730886"},{"key":"154516","doi-asserted-by":"crossref","unstructured":"Li C, Kong L, Shi X, et al. Predictive factors of distal radioulnar joint nstability after surgical treatment of distal radius fractures. Medicine (Baltimore). 2023;102(48):e36505.","DOI":"10.1097\/MD.0000000000036505"},{"key":"154517","doi-asserted-by":"crossref","unstructured":"Huang HK, Wu CH, Wang JP. Distal radioulnar joint instability in distal radius racture. J Hand Surg Asian Pac Vol. 2025;30(6):571\u2013581.","DOI":"10.1142\/S2424835525400090"},{"key":"154518","doi-asserted-by":"crossref","unstructured":"Andersson JK, Axelsson P, Stromberg J, et al. Patients with triangular ibrocartilage complex injuries and distal radioulnar joint instability have reduced otational torque in the forearm. J Hand Surg Eur Vol. 2016;41(7):732\u2013738.","DOI":"10.1177\/1753193415622342"},{"key":"154519","doi-asserted-by":"crossref","unstructured":"Nicolaidis SC, Hildreth DH, Lichtman DM. Acute injuries of the distal radioulnar joint. Hand Clin. 2000;16(3):449\u2013459.","DOI":"10.1016\/S0749-0712(21)00586-2"},{"key":"154520","doi-asserted-by":"crossref","unstructured":"Fujitani R, Omokawa S, Akahane M, et al. Predictors of distal radioulnar joint instability n distal radius fractures. J Hand Surg Am. 2011;36(12):1919\u20131925.","DOI":"10.1016\/j.jhsa.2011.09.004"},{"key":"154521","doi-asserted-by":"crossref","unstructured":"Shen J, Papadonikolakis A, Garrett JP, et al. Ulnar-positive variance as a predictor of distal radioulnar joint ligament disruption. J Hand Surg Am. 2005;30(6):1172\u20131177.","DOI":"10.1016\/j.jhsa.2005.06.014"},{"key":"154522","doi-asserted-by":"crossref","unstructured":"Omokawa S, Iida A, Kawamura K, et al. A biomechanical perspective on distal radioulnar joint instability. J Wrist Surg. 2017;6(2):88\u201396.","DOI":"10.1055\/s-0037-1601367"},{"key":"154523","doi-asserted-by":"crossref","unstructured":"Ding BTK, Pillay K, Sechachalam S. Radial shaft fracture obliquity as a predictor of distal radioulnar joint instability. J Hand Surg Eur Vol. 2018;43(7):732\u2013738.","DOI":"10.1177\/1753193418756591"},{"key":"154524","doi-asserted-by":"crossref","unstructured":"Rhee PC, Medoff RJ, Shin AY. Complex distal radius fractures: an anatomic algorithm for surgical management. J Am Acad Orthop Surg. 2017;25(2):77\u201388.","DOI":"10.5435\/JAAOS-D-15-00525"},{"key":"154525","doi-asserted-by":"crossref","unstructured":"Rampazzo A, Gharb BB, Brock G, et al. Functional outcomes of the Aptis-Scheker distal radioulnar joint replacement in patients under 40 years old. J Hand Surg Am. 2015;40(7):1397\u20131403.e3.","DOI":"10.1016\/j.jhsa.2015.04.028"},{"key":"154526","doi-asserted-by":"crossref","unstructured":"Bellevue KD, Thayer MK, Pouliot M, et al. Complications of semiconstrained distal radioulnar joint arthroplasty. J Hand Surg Am. 2018;43(6):566.e1\u2013e9.","DOI":"10.1016\/j.jhsa.2017.11.004"},{"key":"154527","doi-asserted-by":"crossref","unstructured":"Ross M, Di Mascio L, Peters S, et al. Defining residual radial translation of distal radius fractures: a potential cause of distal radioulnar joint instability. J Wrist Surg. 2014;3(1):22\u201329.","DOI":"10.1055\/s-0033-1357758"},{"key":"154528","doi-asserted-by":"crossref","unstructured":"Moritomo H. The function of the distal interosseous membrane and its relevance to the stability of the distal radioulnar joint: an anatomical and biomechanical review. Handchir Mikrochir Plast Chir. 2015;47(5):277\u2013280.","DOI":"10.1055\/s-0035-1545348"},{"key":"154529","doi-asserted-by":"crossref","unstructured":"Omokawa S, Iida A, Fujitani R, et al. Radiographic predictors of DRUJ instability with distal radius fractures. J Wrist Surg. 2014;3(1):2\u20136.","DOI":"10.1055\/s-0034-1365825"},{"key":"154530","doi-asserted-by":"crossref","unstructured":"Nakamura T, Iwamoto T, Matsumura N, et al. Radiographic and arthroscopic assessment of DRUJ instability due to foveal avulsion of the radioulnar ligament in distal radius fractures. J Wrist Surg. 2014;3(1):12\u201317.","DOI":"10.1055\/s-0033-1364175"},{"key":"154531","doi-asserted-by":"crossref","unstructured":"Boyd B, Adams J. Distal radioulnar joint instability. Hand Clin. 2021;37(4):563\u2013573.","DOI":"10.1016\/j.hcl.2021.06.011"},{"key":"154532","doi-asserted-by":"crossref","unstructured":"Poppler LH, Moran SL. Acute distal radioulnar joint instability: evaluation and treatment. Hand Clin. 2020;36(4):429\u2013441.","DOI":"10.1016\/j.hcl.2020.07.005"}],"container-title":["Journal of Plastic Surgery and Hand Surgery"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/46005\/53794","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/download\/46005\/53794","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T14:24:28Z","timestamp":1778077468000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/JPHS\/article\/view\/46005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,6]]},"references-count":23,"URL":"https:\/\/doi.org\/10.2340\/jphs.v61.46005","relation":{},"ISSN":["2000-6764"],"issn-type":[{"value":"2000-6764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,6]]}}}