Distal symptomatic postraumatic Radioulnar instability (DSPRI) in childs. Functional and imaginological correlation. Case Series

Abstract

Background: Currently, the prevalence, diagnosis and management of distal symptomatic posttraumatic radioulnar instability (DSPRI) in pediatric patients is not well established, and the literature on this is scarce. the purpose of the study is to objectively establish the symptoms and functionality.
Methods: We present a case series study in which 126 patients with a distal forearm fracture were evaluated between February and November 2017, who consulted the emergency department of the Guillermo Grant Benavente Hospital, Concepción, Chile. For the evaluation of the patients, the Quick-DASH, Mayo Wrist Score, comparative grip strength by dynamometer and its imaging correlation by abbreviated CAT scan of the wrist were used using 3 methods to evaluate joint congruence.
Results: 11 patients (8.7%) evolved with DSPRI, most of them male (83%), with a mean age of 10.4 years (4 to 14 years), 82% of right-handed patients, 45% suffered a fracture of the right upper limb, 92% of the patients had a level drop, 73% being low energy and all the patients were treated with orthopedic reduction and brachypalmar cast with an average of 5.5 weeks (2-9 weeks) and an average total follow-up. 10.2 weeks.
Discussion: Post-traumatic DSPRI in pediatric patients is not due to poor fracture reduction and poor alignment axis, but to underdiagnosed ligament injury.
Evidence Level: IV