Evaluation of distal radioulnar joint fixation using a fixation button in galeazzi fracture dislocations: Radiological and functional outcomes

A Galeazzi fracture, characterized by a distal radial diaphyseal fracture and distal radioulnar joint (DRUJ) instability, is diagnosed via X-ray. Following surgical fixation of the radius, DRUJ stability has to be assessed. Unstable DRUJ necessitates surgical intervention, while stable DRUJ is managed with cast immobilization. This study aimed to introduce a novel surgical technique for the fixation of unstable DRUJ with an ONButton™ that promotes early mobilization and stability of DRUJ in Galeazzi fracture-dislocation and evaluate the radiological and functional outcome in 15 patients who visited the Tertiary Care Centre, Base Hospital, Lucknow. A total of 15 patients diagnosed with Galeazzi fractures were enrolled in this investigation and treated at our center from June 2019 to May 2020. A single surgical team performed all patients' surgeries within seven days of injury. DRUJ stability was assessed preoperatively. Unstable fractures were percutaneously fixated using an ONButton™ with fiber wire under fluoroscopic guidance using a beath pin. Subsequently, the diaphyseal radial fracture was fixated with a compression plate (LCDCP/DCP). Following fixation, DRUJ stability was re-evaluated using the piano key test with volar, dorsal, and neutral rotational stress applied to the DRUJ in supination, protonation, and neutral forearm positions. Fifteen patients (12 males, 3 females) with stable DRUJ confirmed by radiograph at 6, 12, and 24 weeks post-surgery were followed up for 6 months. At 6 months, 12 patients achieved excellent results, and 2 patients showed good results. Range of motion, Mikic clinical outcome score, and Mayo modified write score were used to evaluate the functional outcomes. Three patients had terminal supination restriction, and five had terminal protonation restriction, but no significant limitations in the overall range of motion were observed. Percutaneous ONButton™ fixation for DRUJ fractures demonstrates promise as a surgical intervention, achieving high patient satisfaction.