Vol. 11, Issue 2 (2025)

Background: Isolated distal radioulnar joint (DRUJ) instability is frequently underdiagnosed, particularly in the absence of accompanying fractures. If left untreated, it can lead to chronic pain, reduced range of motion, and long-term disability. While K-wire fixation has traditionally been used to manage DRUJ instability, it carries risks such as migration, infection, and insufficient rotational stability.

Aim: To evaluate the functional outcome of chronic, neglected, painful isolated DRUJ instability treated using cannulated cancellous/Herbert screws.

Materials and Methods: A prospective interventional study was conducted between January 2019 and December 2024 in the Department of Orthopaedics at King George Hospital. Fifteen patients (>6 weeks post-injury) with isolated painful DRUJ instability were included. All underwent fixation with cannulated cancellous screws. Patients were assessed postoperatively at intervals of 3 weeks, 6 weeks, 2 months, 6 months, and 1 year using stress tests, imaging, and the Mayo Modified Wrist Score (MMWS). Supination and pronation movements were initiated after screw removal at 8 weeks.

Results: The mean patient age was 37.3 years (range: 18–52). At one-year follow-up, all patients demonstrated DRUJ stability, with improved grip strength and pain relief. Based on MMWS, 6 patients had excellent outcomes, 7 had good, 1 satisfactory, and 1 poor outcome. No complications such as infection, screw migration, or instability were observed.

Conclusion: Fixation of chronic DRUJ instability using cannulated cancellous or Herbert screws yields superior outcomes compared to K-wire fixation. This method provides enhanced joint stability, reduces the risk of complications, and supports reliable functional recovery in chronic cases.