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Volar long radiolunate ligament
3%
177/6499
Radioscaphocapitate ligament
183/6499
Dorsal radioulnar ligaments
90%
5832/6499
Ligament of Testut and Kuentz
2%
99/6499
Scapholunate ligament
172/6499
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Figure A shows a fracture of the distal 1/3 of the radius. This fracture is often associated with dislocation of the distal radioulnar joint (DRUJ). When the two injuries are present together, it is commonly referred to as a Galeazzi fracture. DRUJ instability is a result of injury to the volar and dorsal radioulnar ligaments which are the primary stabilizers of this joint. Imaging often shows widening of the DRUJ on AP view, dorsal or volar displacement on lateral view and radial shortening. Treatment of a Galeazzi injury is operative, consisting of open reduction and internal fixation of the radius with a plate and screw construct, followed by intraoperative assessment of DRUJ alignment. The referenced study by Giannoulis et al is an excellent review of Galeazzi fractures and treatment methods. Ward et al found in a cadaver study that the most significant increases in translation of the wrist occurred after sectioning the dorsal radioulnar ligament in pronation and after sectioning the palmar radioulnar ligament in supination. This patient's AP radiograph is shown in illustration A, and this shows an obvious DRUJ dislocation. Incorrect answers Choice 1,2,4 and 5 are not associated with injury of the DRUJ
4.4
(34)
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