Radiocarpal fracture-dislocation

Clinical Orthopaedics and Related Research, 1985

Radiocarpal dislocation is a rare injury. The authors reviewed seven cases with this injury and identified two groups of patients. Type I involves a dislocation of only the radiocarpal joint, while Type I1 involves intercarpal dislocation also. Four patients were included in Type I dislocation (3 dorsal and 1 volar). The other three patients had Type I1 dislocations, all of which were volar dislocations. Two patients had evidence of injury to the median and ulnar nerves a t the time of the injury and both recovered completely. Closed reduction was possible with good results in three patients with Type I dislocation. All patients with Type I1 dislocation required open reduction and all had residual problems. The distinction between Type I and Type I1 is essential in order to evaluate the full extent of the injury. Closed reduction should always be attempted in Type I dislocation. Type I1 dislocation should be treated by open reduction and repair of all torn ligaments. Radiocarpal dislocations are rare injuries; they represent about .2% of all dislocation^.^*^ Most of the articles written about the subject are in the form of case report^'^^*^*^^.'^.'^ or are part of reviews of fracture-dislocations about the ~r i s t .~,~,~ These injuries are often associated with a fracture of the distal radius3 and are traditionally classified as volar or dorsal according to the direction of hand displacement. The treatment of such injuries was varied

2020

Apergis Emmanuel MD, PhD Director of Orthopaedic Department. Red Cross Hospital-Athens e-mail: [email protected] Radiocarpal fracture-dislocations are the most debatable of carpal dislocations. The term radiocarpal fracture-dislocations has been used incorrectly for many previously reported cases. Thus, many questions arise concerning their incidence, terminology and classification. In this review, an attempt is made to determine the criteria based on which an injury can be classified as radiocarpal fracture-dislocation. Additionally, the surgical treatment of radiocarpal fracture-dislocations with combined access, allows for a relatively accurate description of osteoligamentous injuries, both on the palmar and on the dorsal side of the wrist. Four types of injuries in the dorsal and two types of injuries in the palmar dislocations are portrayed. Furthermore, a new classification is proposed based on five parameters: those of chronicity, pathoanatomy, direction, associated injuries ...

Acta orthopaedica Belgica, 2002

We report a case of dorsal radiocarpal fracture dislocation with dissociation of the distal radioulnar joint. Closed reduction was unsuccessful due to interposition of the osteochondral fragments and open reduction and fixation was carried out with a satisfactory end result. The advantages of volar approach and use of external fixator in the management of this injury are discussed.

Orthopedics, 2013

Radiocarpal fracture-dislocations are uncommon injuries, comprising a spectrum of trauma to the capsuloligamentous complex and osseous structures of the radiocarpal joint along with the adjacent structures. Management guidelines are derived from limited case series and expert opinions. An understanding of the relevant anatomy suggests that restoration of an anatomically reduced joint in conjunction with repair or reconstruction of the osseous and soft tissue structures optimizes outcome. Special consideration should be given to repair of the radial styloid, intercarpal ligaments, and radiocarpal capsuloligamentous complex. The authors report 2 patients with radiocarpal fracture-dislocations in which reduction and stabilization of the carpus was achieved using suture anchor fixation of the volar extrinsic radiocarpal ligaments.

The Journal of Hand Surgery, 1992

The first reported case of posttraumatic multidirectional instability of the radiocarpal joint is described with a review of the relevant literature. A 31-year-old man sustained a palmar radiocarpal dislocation that also dislocated dorsally with gentle provocation and showed ulnar translation and a dorsal intercalated segmental instability pattern after closed reduction. Treatment consisted of open reduction and internal fixation with 11 weeks of immobilization. Follow-up at 32 months showed excellent clinical and radiographic results. Multidirectional instabilities of the radiocarpal joint can occur with radiocarpal dislocation, and one must look for them when planning treatment. Anatomic realignment of the bones and joints is recommended to allow soft tissue healing and prevention of secondary ligamentous laxity. (J HAND SURC 1992;17A:756-61.)

Acta Ortopédica Brasileira, 2022

Introduction The radiographic and surgical findings, and treatment of radiocarpal fracture dislocations, were analyzed retrospectively in 40 patients. Materials and Methods All patients were classified according to Dumontier´s radiological classification and compared with the surgical findings. Based on this analysis, a new classification and treatment are proposed. Results From 1995 to 2018, 40 patients with radiocarpal fracture dislocation underwent surgery. Thirty-six were males and four were females. The mean age was twenty-four years (range: 18-45). Three dislocations were volar dislocations and 37 were displaced dorsally. Initially, 8 (20%) patients were classified as group I, 29 (72.5%) as group II, and 3 (7.5%) remained unclassified. The main variations occurred in group II. Seven fractures were stable after radial styloid fixation and 6 remained unstable. Sixteen fractures presented articular fragments or an interposed capsule, which prevented anatomical reduction using con...

Injury, 1987

The Journal of Hand Surgery, 2012

Purpose We tested the hypothesis that there are no differences between apparently isolated fractures of the radial diaphysis and isolated fractures of the radial diaphysis with concomitant dislocation of the distal radioulnar joint (DRUJ) in function, disability, and DRUJ stability more than 13 years after near-anatomic open reduction with plate and screw fixation. Methods We evaluated 17 adult patients with a diaphyseal fracture of the radius without a fracture of the ulna an average of 19 years after surgery (range, 13-33 y). Of these patients, 7 had concomitant dislocation of the DRUJ (Galeazzi fracture). At the long-term follow-up, we evaluated function with several composite scores, stability of the DRUJ, and arm-specific disability by using the Disabilities of Arm, Shoulder, and Hand questionnaire. Results The average scores were 96 (range, 85-100) on the Mayo Modified Wrist Score, 95 (range, 80-100) on the Mayo Elbow Performance Index, and 5 (range, 0-33) on the Disabilities of Arm, Shoulder, and Hand questionnaire. There were no significant differences between patients with and without DRUJ dislocation. No patients had greater laxity of the DRUJ than the opposite uninjured side. Conclusions Near-anatomic open reduction and internal fixation of diaphyseal radius fractures with and without associated DRUJ dislocation have comparable long-term results.

Strategies in trauma and limb reconstruction (Online), 2009

Isolated acute distal radioulnar joint (DRUJ) dislocation is a rare injury (Garrigues and Aldridge III in J Bone Joint Surg Am 89:1594-1597, 2007]. Reports of isolated DRUJ luxations, volair or dorsal, are often case reports and rarely a series of cases [Dameron Jr in Clin Orthop Relat Res 83:55-63, 1972]. We present a case of an acute traumatic dorsal DRUJ dislocation treated with cast immobilization with recurrence of the dislocation after a new trauma some months later. At follow-up, 17 months after the first dislocation and 9 months after the second, he experienced no pain and had no restrictions in work or sports-related activities.

Clinical Orthopaedics and Related Research, 1996

The most common cause of residual wrist disability after fractures of the distal radius is the distal radioulnar joint. The 3 basic conditions that produce radioulnar pain and limitation of forearm rotation are instability, joint incongruency, and ulnocarpal abutment. The last 2 entities initiate irreversible cartilage damage that eventually leads to degenerative joint disease. Early recognition and management in the acute stage aim at the anatomic reconstruction of the distal radioulnar joint including bone, joint surfaces, and ligaments in an effort to reduce the incidence of painful sequelae and functional deficit. This article provides a description and the treatment options of the distal radioulnar joint lesions that occur in association with fractures of the distal radius, and the results obtained with open and arthroscopic techniques. Both acute and chronic disorders are analyzed, and a prognostic and treatment oriented classification is presented. Furthermore, the pathoanatomy and management of chronic distal radioulnar joint de-From the