A Stepwise Approach to Management of Open Radiocarpal Fracture-Dislocations: A Case Report

Area of Science:

• Orthopedics
• Trauma Surgery
• Emergency Medicine

Background:

• Radiocarpal dislocations are rare injuries typically resulting from high-energy trauma.
• Open fracture-dislocations present unique challenges due to soft tissue compromise and contamination risk.

Observation:

• A unique case of open radiocarpal fracture-dislocation with progressive neurovascular compromise is presented.
• The injury necessitated immediate and staged management to address both skeletal instability and compromised neurovascular status.

Findings:

• Emergent provisional bedside reduction was successfully performed in the emergency room using manual pressure through open wounds.
• Formal open reduction and internal fixation were completed in a subsequent stage once operating room resources were available.

Implications:

• This case highlights the importance of timely, staged management for complex open radiocarpal injuries.
• Effective provisional reduction in the emergency department can stabilize the injury and facilitate subsequent definitive surgical treatment.