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

Acute isolated volar distal radioulnar joint dislocation: first surgery or conservative?

Isolated distal radioulnar joint (DRUJ) dislocations are referred to as dorsal or volar of neglected isolated volar DRUJ dislocation which was detected at the second dislocations concerning the position of the ulnar head in relationship to the radius. In contrast to large joint dislocations such as a shoulder dislocation, the clinical picture may mimic a simple soft tissue injury and the dislocation may be missed. In this article, we aimed to present a case presentation to the emergency department. Our patient who had no complaint other than wrist pain was diagnosed with volar dislocation on lateral radiography and closed reduction was performed in the emergency department with sedation. There was no recurrence in the follow-up and we achieved a satisfactory result with a painless and unrestricted wrist joint at six months. DRUJ and the ligaments stabilize the joint work in anatomical coordination and play an important role in forearm rotation movement. Traumatic injuries to these structures range from isolated tears to severe fractured dislocations. Isolated DRUJ dislocations are rare. Initial treatment of this injury is closed reduction, post-reduction stability is important and fixation is required in case of instability. Although surgical treatment is performed in cases that cannot be closed reduced and in the presence of instability after reduction, it is possible to obtain successful results in acute cases with closed reduction performed with sedation in emergency departments. For this reason, a conservative approach should be tried before making a surgical decision in these injuries that require special attention in diagnosis.

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

Isolated acute dislocation of the distal radioulnar joint is a rare lesion, and in 50 % of cases goes unrecognized; it may be palmar or dorsal. Its diagnosis is suspected when the wrist is traumatic, painful, with limited pronosupination and no fracture on radiological examination. Treatment is aimed at preventing the development of chronic instability and/or arthrosis, and consists of reduction followed by immobilization.

Isolated Acute Dorsal Distal Radioulnar Joint Dislocation: A Case Report

Introduction

Isolated acute distal radioulnar joint (DRUJ) dislocation is a rare condition and easy undiagnosed. Few cases are reported in the literature about its treatment. We reported a case of an isolated acute traumatic dorsal DRUJ dislocation treated with early reduction and immobilization.

Case Report

We present a case of a 12-year-old female with an isolated dorsal acute DRUJ dislocation. We performed for the early diagnosis a clinical examination, X-rays, and computed tomography scan. We treated this condition with a closed reduction and immobilization in an above-elbow cast for 4 weeks and in a below-elbow brace for 2 weeks. The outcome was good.

Conclusion

Isolated acute dorsal DRUJ dislocation is an uncommon injury; the early diagnosis and timely treatment usually result in good outcome. In our case, an early transition to below-elbow brace results in a faster recovery.

Case report: Isolated acute dorsal distal radioulnar joint (DRUJ) dislocation

Introduction

Isolated acute distal radioulnar joint (DRUJ) dislocation is a rare injury that should be early recognized and treated promptly to avoid the limitation and disability associated with delayed diagnosis and management.

Case presentation

We present a patient with a traumatic dorsal isolated DRUJ dislocation who was successfully treated with a closed reduction and k-wire pinning along with cast immobilization.

Discussion

Previous reports of distal radioulnar joint dislocation have described the mechanics of this injury as well as a guidance to diagnosis and treatment. Closed reduction, stabilization of wrist joint, and early mobilization of elbow joint can help in preserving the joint function and a faster recovery.

Conclusion

Closed reduction under general anesthesia, DRUJ stabilization by k-wire pinning, and above elbow casting can be successful in most cases. We recommend an early transition to below elbow cast to encourage early elbow range of motion and prevent joint stiffness.

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Isolated acute distal radioulnar joint dislocations are rare injuries.

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Early diagnosis and prompt treatment are mandatory to obtain satisfactory outcome.

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Postoperatively, early transition to below-elbow cast prevent elbow stiffness and allows a speedy recovery.