Chronic Volar Distal Radial Ulnar Joint Dislocation: A Case Report with Proposed Treatment Algorithm

Area of Science:

• Orthopedic Surgery
• Radiology
• Trauma Management

Background:

• Chronic distal radioulnar joint (DRUJ) dislocations can be challenging to diagnose, especially when isolated and without obvious fractures on initial radiographs.
• Early and accurate diagnosis is crucial for effective management and preventing long-term wrist dysfunction.

Observation:

• A 34-year-old woman presented with chronic right volar DRUJ dislocation and ulnar styloid fracture, one month after a dog bite.
• Initial radiographs revealed the volar DRUJ dislocation, but isolated dislocations can be subtle and easily overlooked.
• Conservative closed reduction attempts were unsuccessful, necessitating surgical intervention.

Findings:

• Open reduction and stabilization were performed for the chronic volar DRUJ dislocation.
• The case underscores the importance of considering DRUJ pathology in patients with persistent wrist pain and limited motion, even after seemingly minor injuries.
• A specific surgical technique and fixation algorithm were employed for this complex case.

Implications:

• This case contributes to the understanding of managing chronic and complex distal radioulnar joint dislocations.
• The presented surgical approach may offer a viable solution for similar challenging cases, improving patient outcomes.
• Highlights the need for heightened radiologic awareness for subtle DRUJ injuries.