Both Bone Forearm Fracture with Complex DRUJ Dislocation: What Are the Odds?

Area of Science:

• Orthopedic Surgery
• Traumatology
• Anatomy

Background:

• Distal radioulnar joint (DRUJ) dislocations can be simple or complex, occurring with radius fractures (Galeazzi) or, rarely, both bone forearm fractures.
• Complex DRUJ dislocations, unlike simple ones, resist closed reduction and require specific management strategies.
• The association of complex DRUJ dislocation with a both bone forearm fracture represents an exceptionally uncommon injury pattern.

Observation:

• This report details two cases of both bone forearm fractures with complex DRUJ dislocation.
• Intraoperative findings revealed the ulnar head buttonholed through the extensor retinaculum between extensor tendons in both patients.
• Management involved open reduction via a dorsal approach, with timely intervention leading to good patient outcomes.

Findings:

• Complex DRUJ dislocation in the context of a both bone forearm fracture is exceedingly rare, with only three prior cases documented in the literature.
• Surgical intervention, specifically open reduction, is crucial for complex DRUJ dislocations associated with these fractures.
• Anatomical reduction and appropriate fixation are key to successful treatment.

Implications:

• Highlights the unusual association of complex DRUJ dislocation with both bone forearm fractures, emphasizing the need for prompt recognition.
• Underscores the importance of the sequence of fixation in managing these complex injuries.
• Advocates for timely and appropriate intervention to achieve favorable outcomes in this rare injury pattern.