Locking of the distal radio-ulnar joint due to loose bodies

Wan, A. C. T.; Lunn, P. G.

doi:10.1016/0266-7681(89)90093-4

Cited by 2 publications

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References 3 publications

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“…Only 5 cases of locking of the DRUJ have previously been reported in the literature. [1][2][3][4][5] The present case is the first report of locking of the DRUJ due to a tear of the RUL. ►Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Locking of the distal radioulnar joint (DRUJ) has been reported in five case reports. [1][2][3][4][5] Previous reports described the causes of locking to include interposition of the extensor carpi ulnaris (ECU), 1 loose bodies, [2][3][4] or DRUJ capsule. 5 Although a tear of the triangular fibrocartilage complex (TFCC) may be another possible cause, this has not yet been described.…”

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Subluxation of the Palmar Radioulnar Ligament As a Cause of Blocked Forearm Supination: A Case of DRUJ Locking

et al. 2013

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Locking of the distal radioulnar joint (DRUJ) has been reported in five case reports.1-5 Previous reports described the causes of locking to include interposition of the extensor carpi ulnaris (ECU), 1 loose bodies, 2-4 or DRUJ capsule. 5 Although a tear of the triangular fibrocartilage complex (TFCC) may be another possible cause, this has not yet been described. We now report a case of painful locking of the DRUJ with normal pronation, but severely restricted supination due to a dislocated flap of the palmar portion of the radioulnar ligament (RUL) avulsed horizontally from the TFCC; this locking was successfully released arthroscopically. Case ReportWhile moving furniture, a right-handed 35-year-old woman suddenly felt ulnar-sided pain in her right wrist and a subsequent restriction of supination. The problem persisted despite 4 weeks of cast immobilization. Four months later, she visited our hospital. On physical examination there was tenderness over the distal prominence of the ulnar head. Wrist flexion-extension and radial-ulnar deviation were normal. She could fully pronate, but supination was blocked at 15°. There was no clinical evidence of DRUJ instability. The ulnar head could not translate normally from dorsal to palmar on the sigmoid notch of the radius while attempting pronosupination. Radiographs were normal, with a neutral ulnar variance. An arthrogram showed leakage of the contrast medium from the radiocarpal joint into the DRUJ and also into a "doublefloored" triangular fibrocartilage (TFC), which overlapped the ulnar head. This demonstrated "beak-like" shadow of the proximal TFC (►Fig. 1). An MRI was not helpful in delineating a TFC tear.Five months after the initial injury, we performed diagnostic radiocarpal and DRUJ arthroscopy. We found a slit tear in the central portion of the articular disk (►Fig. 2a). We elevated the central longitudinal slit with a probe and noted mild chondromalacia on the palmar aspect of the ulnar head (►Fig. 2b). We advanced the arthroscope through the tear into the DRUJ and found a bundle, corresponding to the palmar radioulnar ligament (RUL), located at the proximopalmar side of the ulnar head (►Fig. 2c), that tensed up and blocked palmar translation of the ulnar head with attempted passive supination. The elevator was inserted to the palmar side of the ulnar head, and elevated the RUL (►Fig. 2d), which then allowed normal supination. Keywords► locking ► distal radioulnar joint ► triangular fibrocartilage complex ► pronation contracture ► radioulnar ligament AbstractWe report a case of locking of the distal radioulnar joint (DRUJ) due to interposition of a flap of the palmar radioulnar ligament (RUL) torn from the triangular fibrocartilage complex (TFCC). We released the blockage by elevating the flap and partially resecting a portion of the triangular fibrocartilage (TFC) arthroscopically.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Subluxation of the Palmar Radioulnar Ligament As a Cause of Blocked Forearm Supination: A Case of DRUJ Locking

et al. 2013

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Locking of the Distal Radioulnar Joint Caused by Dorsal Tear of the Triangular Fibrocartilage Complex

Kawabata

Nimura

Fujita

et al. 2020

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Case: We encountered a case of locking of the distal radioulnar joint after a traumatic injury that restricted the supination and pronation of the wrist. The locking was released surgically with a good 2-year outcome. We found a tear between the dorsal aspect of the joint capsule and the triangular fibrocartilage complex (TFCC). The tear allowed the TFCC to displace volarly and become entrapped against the volar aspect of the ulnar head. Conclusion: The open approach facilitated visualization and understanding of this unusual injury pattern and allowed direct repair. Joint incongruity may not occur despite a locked joint.

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Locking of the distal radio-ulnar joint due to loose bodies

Abstract: A patient is described in whom loose bodies in the distal radio-ulnar joint caused intermittent locking of rotation of the forearm.

Cited by 2 publications

References 3 publications

Subluxation of the Palmar Radioulnar Ligament As a Cause of Blocked Forearm Supination: A Case of DRUJ Locking

Subluxation of the Palmar Radioulnar Ligament As a Cause of Blocked Forearm Supination: A Case of DRUJ Locking

Locking of the Distal Radioulnar Joint Caused by Dorsal Tear of the Triangular Fibrocartilage Complex

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