Radiocarpal Dislocations: Review of the Literature With Case Presentations and a Proposed Treatment Algorithm

Mourikis, Anastasios; Rebello, Gleeson; Villafuerte, Javier; Moneim, Moheb S.; Omer, George E.; Veitch, John M.

doi:10.3928/01477447-20080401-24

Cited by 18 publications

(14 citation statements)

References 17 publications

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“…The latter type of dislocation lacks a bony scaffold for anatomic restoration of the radiocarpal ligaments, often resulting in inferior outcomes. This important distinction is supported by multiple other case reports in which, despite open repair, radiocarpal relationships were not maintained in pure ligamentous injuries [3,7,9].…”

Section: Discussionsupporting

confidence: 63%

“…Despite aggressive treatment, maintaining normal radiocarpal relationships can be difficult [7,9]. When these methods fail, a salvage procedure such as radioscaphoid, radiolunate, or total wrist arthrodesis becomes necessary [3,4,[7][8][9], prompting several authors to recommend some form of primary arthrodesis as the index procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Palmar radiocarpal dislocations are rare injuries, often with devastating functional consequences [4,7]. Insufficient ligamentous healing is considered to be the cause of the frequent complication of ulnar translocation of the carpus, defined as an increase in space between the radial styloid and scaphoid with displacement of the lunate over the distal ulna [2,8,9].…”

Section: Discussionmentioning

confidence: 99%

“…Surgical treatment includes primary ligamentous repair [8,9] combined with percutaneous pinning, with or without external fixation [3,7]. Despite aggressive treatment, maintaining normal radiocarpal relationships can be difficult [7,9].…”

Section: Discussionmentioning

confidence: 99%

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Palmar Radiocarpal Dislocation: A Case Report and Novel Treatment Method

Obafemi

Pensy

2011

Hand (New York, N,Y.)

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Palmar Radiocarpal Dislocation: A Case Report and Novel Treatment Method

Obafemi

Pensy

2011

Hand (New York, N,Y.)

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“…The mechanism of injury seems to be high-energy axial loading combined with torsional forces to the hyperextended and pronated wrist in which the most important wrist stabilizing extrinsic ligaments are ruptured. The lesions usually are the result of falls from a height or motor-vehicle accidents mostly in young active men with age ranging from 20 to 40 years, and they are usually accompanied by visceral as well as musculoskeletal injuries, whereas low-energy injuries are very rare [1,[4][5][6]. The pathology is extremely infrequent with an incidence of 0,2% of all dislocations [3,7].…”

Section: Case Presentationmentioning

confidence: 99%

Posttraumatic ulnar carpal translocation type I accompanied with disruption of the lunotriquetral ligament caused by a severe radiocarpal fracture-dislocation injury type II accompanied with complete luxation of the distal radioulnar joint. What are the salvage options with its special features in indication when patients develop posttraumatic painful wrist joint osteoarthritis?

Schmidt¹

2017

Trauma Emerg Care

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Key words: radiocarpal fracture-dislocation injury, dorsal rim fracture distal radius, luxation distal radioulnar joint, posttraumatic ulnar carpal translocation, volar intercalated segment instability, denervation of the wrist, salvage options for posttraumatic wrist joint osteoarthritis Case presentationA 24-year-old right-handed male sustained a severe closed right radiocarpal fracture-dislocation injury (RCFDI) due to high-energy fall on his hyperextended wrist by a motorcycle accident with speed of 102,5 miles per hour. The initial radiographs showed complete dislocation of the wrist in dorsal direction accompanied with a displaced dorsal rim fracture of the articular surface of distal radius, a displaced intraarticular radial styloid fracture involving much more than one third of the articular surface of distal radius (type II), and complete luxation of distal radioulnar joint (DRUJ) in volar direction (Figure 1). Accompanying visceral, vascular or nerve injuries were not present, but closed non-displaced fractures of the left metatarsal bones II/III. First, the closed reduction and external fixation (CREF) of the wrist and DRUJ with additional radioulnar transfixation using two K-wires was performed. The postoperative computed tomography (CT) scans demonstrated complete restoration of anatomic alignment in both joints ( Figure 2A). Five days after that, the swelling around the wrist had improved, and so, the open reduction and internal fixation (ORIF) of radial styloid fracture using two 3,0 mm cannulated headless titanium compression screws (medartis®, Basel/Switzerland) could be performed that was accompanied with removal of external fixation and early denervation of the wrist ( Figure 2B). Intraoperatively, there was no radiocarpal re-luxation tendency in dorsal direction related to the accompanying dorsal rim fracture, and so its surgical reduction was not necessary. The right upper extremity was immobilized with a plaster splint involving the elbow and wrist joints for another five weeks. After that, the plaster splint and the two K-wires for radioulnar transfixation were removed, and the movement of the wrist was freed accompanied with pain-related gradual increase of load. The left non-displaced fractures of the metatarsal bones II/III were treated conservatively with a plaster splint for six weeks. Fourteen weeks after injury, the patient could be reemployed completely in his original occupation as a mechanic in a professional motorcycle racing team. At the 1-year follow-up, the postero-anterior (PA) and lateral radiographs showed distinctive posttraumatic ulnar carpal translocation (PUCT) of the entire carpus (type I) in comparison to the uninjured left wrist that was accompanied with marked volar angulation of the scaphoid bone in the absence of disruption of scapholunate ligament (SLL), but in the presence of disruption of the lunotriquetral ligament (LTL) with distinctive volar intercalated segment instability (VISI) ( Figure 3A-B). However, the patient rated his pain in visual analogue score ...

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Radius and Ulna

Sweeney¹,

Gregory²,

Wingfield³

et al. 2020

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Radiocarpal Dislocations: Review of the Literature With Case Presentations and a Proposed Treatment Algorithm

Cited by 18 publications

References 17 publications

Palmar Radiocarpal Dislocation: A Case Report and Novel Treatment Method

Palmar Radiocarpal Dislocation: A Case Report and Novel Treatment Method

Radius and Ulna

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