Isolated Volar Distal Radioulnar Joint Dislocation

Isolated Volar Dislocation of the Distal Radioulnar Joint Treated With Successful Closed Reduction

We report the case of A 34-year-old right-hand-dominant male who presented with an isolated left volar dislocation of the distal radioulnar joint (DRUJ) without any associated fractures. The patient had sustained the injury in an altercation in the evening prior to the presentation and had woken up the next morning with left wrist pain and restricted wrist motion. Closed reduction was successful under conscious sedation and the patient was treated conservatively with splint immobilization without needing operative intervention.

This report highlights a rare injury pattern - an isolated volar DRUJ dislocation - that was successfully closed reduced, despite reports that this injury pattern frequently requires open reduction.

Isolated Volar Dislocation of the Distal Radioulnar Joint: A Case Report

Introduction

Isolated dislocation of the distal radioulnar joint (DRUJ) is a rare phenomenon. Approximately 50% of isolated DRUJ dislocations are undiagnosed or diagnosed late with significant functional consequences. This clinical injury is rarely described in the literature and management is not well established. We reported a case of volar DRUJ dislocation early diagnosed.

Case Report

A 36-year-old man was diagnosed with an isolated volar dislocation of the DRUJ. The clinical examination, X-rays, and computed tomography scan allowed an early diagnosis. A reduction by external maneuvers was performed and the patient was immobilized in an above elbow plaster cast for 6 weeks. Magnetic resonance imaging did not reveal any capsuloligamentous lesions requiring surgery. Evolution was favorable.

Conclusion

Isolated volar dislocation of the DRUJ is an uncommon injury which can be easily missed. Missed or late diagnosis may lead to significant morbidity. Early diagnosis and treatment of such injuries usually results in excellent functional recovery.

Subtle radiographic findings of acute, isolated distal radioulnar joint dislocation

Distal radioulnar dislocations typically occur in association with fractures of the distal radius and/or ulna. Rare isolated dislocations or subluxations are more difficult to diagnose and are initially missed in up to 50 % of cases. We present two cases of missed isolated volar rotatory dislocation of the distal radioulnar joint. Subtle, overlooked radiographic findings of abnormal radioulnar alignment and ulnar styloid projection are highlighted. The supplemental role of cross-sectional imaging is reviewed. Adequate clinical information, appropriate radiographic technique, and high index of suspicion are necessary for the accurate and timely diagnosis of this rare injury pattern.

Non-reducible palmar dislocation of the distal radioulnar joint

A rare case of an isolated traumatic palmar dislocation of the distal radioulnar joint is presented. Clinically, there is a loss of pronation and supination. The dislocation was treated using an open reduction, reinsertion of the capsule-ligamentous complex and temporary stabilization using K-wires.

Simultaneous dislocation of the radiocapitellar and distal radioulnar joints without fracture: case report

Simultaneous dislocation of the distal radioulnar joint and the radial head without fracture is an uncommon injury. Prior reports have described closed treatment of this injury. We report a case of paired dislocation without fracture that required open reduction of both articulations in the acute setting. Potential mechanisms responsible for this pattern and recommendations for management of similar patients are described.