Dataset Information

Volar dislocation of the ulnar head after distal radial fracture: Case report and review of the pertinent literature.

ABSTRACT:

Introduction

We report the case of volar dislocation of the ulnar head occurred after osteosynthesis for the treatment of distal radius fracture.

Presentation of case

The patient, 68-year-old female, had the dorsal displaced left distal radius fracture and volar dislocation of the ulnar head. Osteosynthesis was performed using a volar locking plate without postoperative immobilization. Two weeks after surgery, volar dislocation of the ulnar head in distal radioulnar joint (DRUJ) was noted on CT. Re-operation, triangular fibrocartilage complex (TFCC) was sutured to the ulnar fovea using a suture anchor, was performed in order to stabilize DRUJ. At 24 months after surgery, left wrist joint pain and the range of motion have improved, and the Mayo wrist score was excellent.

Discussion

Based on the fact that the radius was fractured and the ulna was dislocated in DRUJ at the time of injury, the present case may have been a Galeazzi fracture.

Conclusion

When distal radius fracture is complicated by ulnar instability of DRUJ, active repair of the TFCC function may be necessary to prevent residual postoperative instability.

SUBMITTER: Nagura N

PROVIDER: S-EPMC6197738 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Publications

Volar dislocation of the ulnar head after distal radial fracture: Case report and review of the pertinent literature.

Nagura Nana N Naito Kiyohito K Zemirline Ahmed A Sugiyama Yoichi Y Kinoshita Mayuko M Goto Kenji K Iwase Yoshiyuki Y Kaneko Kazuo K

Annals of medicine and surgery (2012) 20181010

<h4>Introduction</h4>We report the case of volar dislocation of the ulnar head occurred after osteosynthesis for the treatment of distal radius fracture.<h4>Presentation of case</h4>The patient, 68-year-old female, had the dorsal displaced left distal radius fracture and volar dislocation of the ulnar head. Osteosynthesis was performed using a volar locking plate without postoperative immobilization. Two weeks after surgery, volar dislocation of the ulnar head in distal radioulnar joint (DRUJ) w ...[more]

PMID: 30364754

Similar Datasets

Project description:RationaleHabitual volar dislocation of the ulnar head with a locked distal radioulnar joint (DRUJ) is a rare complication after distal radius fracture. We present a case of habitual volar dislocation of the ulnar head in a woman with a dorsally displaced malunited distal radius fracture.Patient concernsA 72-year-old woman presented with occasional painful locking of the forearm in full supination. She had fractured the left distal radius in a fall 6 months previously. The fracture had been treated non-surgically with wrist immobilization in a long and short arm cast for 6 weeks. Physical examination showed no swelling of the left hand. The wrist locked when the forearm was fully supinated, and the patient was not able to pronate her forearm without reducing the ulna by pressing the left ulna down toward the DRUJ. She experienced sharp pain during the reduction procedure and pronation of the left forearm. The affected wrist had 91% motion compared with the contralateral wrist.DiagnosisRadiography and computed tomography showed 28° dorsally angulated malunion of the distal radius and ulnar head subluxation with respect to the radius. Magnetic resonance imaging revealed disruption of the ulnar-side triangular fibrocartilage complex (TFCC) from the ulna fovea.InterventionsThe patient desired surgery to address the painful click during full supination of her left wrist and the limitations in her activities of daily living. Corrective osteotomy of the distal radius and arthroscopic repair of the ulnar-side tear of the TFCC were performed. The TFCC was arthroscopically repaired to the ulnar fovea to stabilize the DRUJ.OutcomesAt 1 year postoperatively, radiography showed complete union of the radius. The affected side had 97% wrist motion compared with the contralateral wrist and a full range of forearm rotation without pain or clicking. The grasp strength was 100% compared with the normal wrist.LessonsMalunited distal radius fracture with concomitant TFCC injury can result in habitual volar dislocation of the ulnar head due to severely dorsally angulated malunion of the radius and avulsion of the ulnar-side TFCC from the ulna fovea. This condition required corrective osteotomy plus TFCC repair.

Dataset Information

Volar dislocation of the ulnar head after distal radial fracture: Case report and review of the pertinent literature.

Introduction

Presentation of case

Discussion

Conclusion

Publications

Volar dislocation of the ulnar head after distal radial fracture: Case report and review of the pertinent literature.

Similar Datasets

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