Download PDF
J Wrist Surg 2021; 10(02): 169-175
DOI: 10.1055/s-0040-1718915
Procedure

Volar Radiocarpal Ligament Repair with Suture Anchors for Radiocarpal Fracture Dislocations: Case Series

Kyle C. Bohm
1   Department of Orthopedic Surgery, Regions Hospital, St Paul, Minnesota
2   Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota
3   Department of Orthopedic Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
,
Jacqueline Geissler 
2   Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota
3   Department of Orthopedic Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
,
Christina M. Ward 
1   Department of Orthopedic Surgery, Regions Hospital, St Paul, Minnesota
2   Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Background Radiocarpal fracture dislocations cause significant intraarticular disruption and instability difficult to treat with traditional plating methods.

Description of Technique Suture anchor fixation of the volar radiocarpal ligaments through an extended carpal tunnel approach, supplemented with radial styloid fixation, restores stability to the radiocarpal joint.

Patients and Methods We performed a retrospective review of 14 consecutive radiocarpal fracture-dislocations (RCFDs) treated at two-level one trauma center from 2011 to 2015. In all cases, the volar radiocarpal ligaments were repaired to the distal radius with suture anchors.

Results We reviewed 14 Dumontier Group 2 RCFDs in 14 patients (10 males, four females) with an average age of 39 years (range 22–53 years). Final follow-up averaged 288 days (range 7–1,364 days). Surgeons performed volar ligament repair with suture anchors in all cases, radial styloid fixation in 79% (11/14), and dorsal plate fixation in 29% (4/14). Eight of 14 patients (57%) had a “flipped” volar lip fragment of the distal radius. Three patients had forearm compartment syndrome and two patients had acute carpal tunnel syndrome. No patients experienced radiocarpal subluxation after volar ligament repair.

Conclusion No recurrent subluxation or dislocation occurred after primary repair of the volar radiocarpal ligaments using suture anchors in this series of radiocarpal fracture dislocations. Volar radiocarpal ligament repair also addressed the “flipped” volar rim fragment that could not be addressed through a dorsal approach alone.

Level of Evidence: This is a Level IV, case series therapeutic study.

Keywords

distal radius fracture - ligament repair - radiocarpal dislocation


Publication History

Received: 29 April 2020

Accepted: 15 September 2020

Article published online:
04 November 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Ilyas AM, Williamson C, Mudgal CS. Radiocarpal dislocation: is it a rare injury?. J Hand Surg Eur Vol 2011; 36 (02) 164-165
    CrossrefPubMedGoogle Scholar
  • 2 Apergis E, Palamidi A. Radiocarpal dislocations or fracture-dislocations. In: Sharareh B, Dunn J. eds. Fracture—Dislocations of the Wrist. Mailand: Springer-Verlag; 2013: 187-237
    Google Scholar
  • 3 Dumontier C, Meyer zu Reckendorf G, Sautet A, Lenoble E, Saffar P, Allieu Y. Radiocarpal dislocations: classification and proposal for treatment. A review of twenty-seven cases. J Bone Joint Surg Am 2001; 83 (02) 212-218
    CrossrefPubMedGoogle Scholar
  • 4 Kamal RN, Bariteau JT, Beutel BG, DaSilva MF. Arthroscopic reduction and percutaneous pinning of a radiocarpal dislocation: a case report. J Bone Joint Surg Am 2011; 93 (15) e84
    CrossrefPubMedGoogle Scholar
  • 5 Nyquist SR, Stern PJ. Open radiocarpal fracture-dislocations. J Hand Surg Am 1984; 9 (05) 707-710
    CrossrefPubMedGoogle Scholar
  • 6 Potter MQ, Haller JM, Tyser AR. Ligamentous radiocarpal fracture-dislocation treated with wrist-spanning plate and volar ligament repair. J Wrist Surg 2014; 3 (04) 265-268
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Mudgal CS, Psenica J, Jupiter JB. Radiocarpal fracture-dislocation. J Hand Surg [Br] 1999; 24 (01) 92-98
    CrossrefPubMedGoogle Scholar
  • 8 Bilos ZJ, Pankovich AM, Yelda S. Fracture-dislocation of the radiocarpal joint. J Bone Joint Surg Am 1977; 59 (02) 198-203
    CrossrefPubMedGoogle Scholar
  • 9 Ilyas AM, Mudgal CS. Radiocarpal fracture-dislocations. J Am Acad Orthop Surg 2008; 16 (11) 647-655
    CrossrefPubMedGoogle Scholar
  • 10 Yuan BJ, Dennison DG, Elhassan BT, Kakar S. Outcomes after radiocarpal dislocation: a retrospective review. Hand (N Y) 2015; 10 (03) 367-373
    CrossrefPubMedGoogle Scholar
  • 11 Girard J, Cassagnaud X, Maynou C. [Radiocarpal dislocation: twelve cases and a review of the literature]. Rev Chir Reparatrice Appar Mot 2004; 90: 426-433
    PubMedGoogle Scholar
  • 12 Brown D, Mulligan MT, Uhl RL. Volar ligament repair for radiocarpal fracture-dislocation. Orthopedics 2013; 36 (06) 463-468
    CrossrefPubMedGoogle Scholar