Distal radioulnar joint (DRUJ) instability
Research type
Research Study
Full title
Distal radioulnar joint (DRUJ) instability after wrist/forearm/elbow/shoulder injuries
IRAS ID
142047
Contact name
Grey Giddins
Contact email
Duration of Study in the UK
2 years, 5 months, 1 days
Research summary
Injuries of the wrist, forearm, elbow and shoulder are usually sustained following a fall on an outstretched hand and may also cause injury and instability to the distal radio-ulnar joint (DRUJ)at the wrist, a potential cause of long term pain. Assessment of DRUJ instability is difficult and variable. Previous studies assessing this using either clinical or radiological assessment report DRUJ instability in 27-50% of wrist fractures. DRUJ instability following other upper limb injuries has never been assessed. Our clinical observation is that the majority of upper limb injuries cause DRUJ instability. The significance of this is unclear. We aim to measure DRUJ instability clinically in 200 patients (aged >18 years) with a previous wrist, forearm, elbow or shoulder injury treated in our unit, using a testing device that we have previously developed and validated (study reference number REC12/SW/0102, RD 01708). We will measure upper limb ranges of motion, DRUJ translation and lengths of the forearm (this is needed to see if DRUJ instability is related to size/gender). Patients will also complete a questionnaire assessing upper limb function and symptoms. We will correlate the information collected with anonymous patient demographics and radiographic assessment. A subgroup of 20 patients will also be assessed clinically by 10 clinicians to assess the accuracy of clinical examination of DRUJ instability compared to measurement with the testing device.
We hypothesize that the majority of patients will have DRUJ instability and this will be the first time this has been measured mechanically. This will help us to better understand the association between upper limb injuries and DRUJ instability. In addition we aim to formally assess the accuracy of clinical assessment. This may help direct further research or interventions to treat patients with ongoing wrist pain and functional limitations after upper limb injuries.REC name
East of Scotland Research Ethics Service REC 1
REC reference
15/ES/0034
Date of REC Opinion
11 Mar 2015
REC opinion
Favourable Opinion