Irreducible Volar DRUJ Dislocation with Distal Radius Fracture Dislocation

Area of Science:

• Orthopedic Surgery
• Traumatology
• Radiology

Background:

• Volar dislocations of the distal radioulnar joint (DRUJ) are uncommon and frequently missed.
• Delayed diagnosis can lead to chronic dislocations and functional disability.
• DRUJ dislocations often present with concomitant wrist injuries, complicating management.

Observation:

• A patient presented with a volar DRUJ dislocation and a dorsal distal radius fracture dislocation.
• Initial closed reduction attempts for the DRUJ were unsuccessful.
• Open reduction and internal fixation of the radius fracture were performed, followed by attempted closed reduction of the DRUJ, which also failed.

Findings:

• Surgical exploration revealed the extensor carpi ulnaris and distal radius anatomy obstructed closed reduction of the DRUJ.
• Open reduction of the DRUJ was performed.
• Postoperatively, the patient exhibited persistent subluxation at 2 and 4 months but reported minimal pain and functional recovery.

Implications:

• This case demonstrates a successful treatment strategy for a complex, irreducible volar DRUJ dislocation associated with a distal radius fracture.
• The findings underscore the importance of surgical intervention when closed reduction fails.
• This report contributes to the limited literature on managing such rare injuries and can guide future clinical practice.