Volar dislocation of the distal radio-ulnar joint. A case report.

Volar dislocation of the distal radio–ulnar joint without fracture: A case report and literature review

“…Early diagnosis and treatment is the key for a good outcome although those injuries where diagnosis is missed and treatment delayed can still have a successful outcome up to seven weeks after the injury. 9 …”

“…9 Examination can reveal a gutter on the dorsal aspect of the wrist with the head of the ulna being palpable on the volar surface but may also show no evidence of deformity 4,9 Standard antero-posterior and lateral radiographs of the wrist should be obtained. The relationship of the distal ulna to the distal radius is important when obtaining lateral radiographs and can alter significantly if the forearm is rotated between 10 and 208 away from neutral.…”

“…In those situations where the DRUJ is deemed unstable and is transfixed with a Kirschner wire, below elbow immobilisation is satisfactory. 9 For those injuries where the diagnosis has been missed and subsequent treatment delayed, closed reduction under anaesthesia is generally required. Furthermore, closed reduction is still possible up to seven weeks after the injury.…”

“…1,9 Early diagnosis and treatment gives a favourable outcome 8 although good function can still be achieved with a delay in treatment of up to seven weeks. 9 Dameron reported two cases where treatment was delayed by six and seven weeks, respectively. A satisfactory outcome was only achieved after resection of the distal ulna 18 months post injury.…”

“…It is an injury that can be missed initially due to subtle signs and interpretation of inadequate radiographs. 4,9,10 The clinician should have a high index of suspicion as early diagnosis and treatment gives a favourable outcome. We present a case of volar dislocation of the distal radio-ulnar joint without an associated fracture, and a review of the literature.…”