Chronic Distal Radioulnar Joint Dislocation: A Case Report

Abstract

Dislocation of the distal radioulnar joint (DRUJ) usually occurs associated with a distal radius fracture. An isolated dislocation, without a radius fracture, is a rare situation.We present a case of neglected isolated DRUJ dislocation in a 30-year-old manual laborer. The treatment was performed 4 months after the initial injury. Open reduction and fixation were performed. This resulted in a stable, pain-free joint, and the patient resumed his previous work.Surgical techniques of foveal reattachment and dorsal capsuloplasty have been described for chronic DRUJ instability. An isolated and dislocated DRUJ is an uncommon injury that may be misdiagnosed and initially mistreated. There haven't been many reports in the literature of a case such as this.

Double suture-button reconstruction for chronic volar dislocation of distal radioulnar joint: A case report

“…In our situation, the chosen treatment (open reduction, TFCC reattachment, and dorsal plicature) is similar to that of previous authors [ 1 , 2 ]. However, the TFCC was completely detached and could not be reattached; furthermore, reconstruction with tendon graft to restore stability carries the risk of fracturing the ulnar head during tunneling for tendon graft passage.…”

“…A DRUJ dislocation is an uncommon occurrence. This injury, if misdiagnosed or mismanaged, causes a total loss of pronation-supination, resulting in a severe functional impairment [ 1 ]. Typically, a closed reduction with the forearm held in protonation is sufficient to treat an acute injury.…”

Mini-invasive Indirect Distraction in the Treatment of Neglected DRUJ Dislocations—A Novel Surgical Technique

“…Larrivée et al (2018) published a single case report of interosseous membrane pressure distraction technique to reduce DRUJ. Irreducible acute or neglected DRUJ dislocations are considered to be an indication of open reduction 13,14 or a salvage procedure. 15 Different causes of irreducibility have been discussed.…”

Isolated dorsal dislocation of the distal radioulnar joint: A case report

“…It is an injury that can be missed initially due to subtle signs and interpretation of inadequate radiographs. This injury, if misdiagnosed or mistreated, results in a complete loss of pronation- supination, which entails a great functional limitation [ 7 ]. The dorsal dislocation is more common with the ulna moving dorsally in relation to the radius following hyperextension of the wrist with hyperpronation forces [ 8 ].…”

“…Because of the vascularity and healing potential of the peripheral TFCC, closed treatment is frequently successful in the restoration of a stable construct [ 10 , 11 ]. If instability persists after reduction, radioulnar pinning is done in reduced position to allow soft tissue healing [ 7 , 12 ], using one or two Kirschner (K) wires just proximal to the DRUJ [ 4 ]. If the dislocation proves to be irreducible even with conscious sedation or general anesthesia, open reduction in combination with repair of the TFCC is recommended [ 9 ].…”