MỐI TƯƠNG QUAN GIỮA LÂM SÀNG, X-QUANG VÀ MRI CỦA KHỚP QUAY TRỤ DƯỚI SAU PHẪU THUẬT ĐIỀU TRỊ GÃY GALEAZZI

Abstract

Introduction: Galeazzi fracture, involving a radius shaft fracture with distal radioulnar joint (DRUJ) dislocation, is commonly treated surgically. Although perfect anatomical restoration of the radius aims to restore DRUJ stability, many patients still experience persistent pain or DRUJ instability, suggesting the possibility of unhealed triangular fibrocartilage complex (TFCC) injuries. This study was conducted to investigate the correlation between clinical outcomes and imaging findings of the DRUJ after surgical treatment for Galeazzi fractures. Methods: A retrospective, cross-sectional descriptive study was conducted on 34 patients who underwent surgical treatment for Galeazzi fracture according to the standard protocol (open reduction and internal fixation [ORIF] of the radius with plate and screws, temporary DRUJ fixation with Kirschner wires if unstable, above-elbow cast in supination) with a minimum follow-up of 12 months. Patients underwent clinical assessment (pain, DRUJ ballottement test, TFCC compression test), functional assessment (ROM, muscle strength, DASH score), radiography (ulnar variance - UV, joint space width – W, DRUJ instability), and MRI (DRUJ instability, TFCC lesion). Results: Clinical functional outcomes were relatively good, with a mean DASH score of 26.44; very good and good pronation-supination ROM reached 79,5%; grip strength and pronation-supination strength were 76.7% and 79.5% respectively, compared to the contralateral side. However, 52.9% of patients still experienced pain, and 26.5% had a positive DRUJ ballottement test. Radiographs showed normal UV and W in 94.1% and 85.3% respectively, but 20.6% showed DRUJ subluxation or dislocation. MRI detected TFCC lesions (Palmer Type 1) in 100% of patients. Conclusion: There is a clear discrepancy between clinical findings and imaging results after standard surgical treatment for Galeazzi fracture. Clinical functional outcomes are relatively good, but MRI detected TFCC lesions in 100% of cases - suggesting this as the cause of persistent pain for more than half of the patients.