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DOI: 10.1055/s-0042-1760260
Locked Distal Ulna Volar Dislocation Associated with a Malunited Fracture of the Distal Radius
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Abstract
Background The volar dislocation of the distal ulna is an uncommon injury and often missed due to its rarity. If diagnosed early, it can be managed with a simple closed reduction followed by immobilization. Open reduction is recommended in case of any interposition preventing reduction.
Case Description In this case report, we present a rare case of neglected volar distal ulna dislocation associated with a distal radius fracture presenting with a fixed supination deformity that was managed successfully with a Sauvé- Kapandji procedure using a modified approach to restore forearm rotation. At 10 months, the patient had a good union at the distal radio ulnar joint (DRUJ) with improved forearm rotations.
Literature Review To our knowledge no previous cases of neglected volar distal ulna dislocation with distal radius fracture has been reported in the literature.
Clinical Relevance If DRUJ stability cannot be restored after closed reduction of distal radius fracture, open reduction and internal fixation of the fracture should always be performed to avoid subsequent DRUJ subluxation/dislocations.
Keywords
distal radioulnar joint - locked volar dislocation - volar distal ulna dislocation - supination - Sauvé-Kapandji procedureInstitution (Affiliated and Place of Study)-
Department of Hand Surgery, Sanjay Gandhi Institute of Orthopaedics and Trauma, Byrasandra, Jayanagar, Bangalore 560011, India
Declaration of Funding
The author(s) received no financial support for the preparation, research, authorship, and/or publication of this manuscript.
Declaration of Ethical Approval for Study
This study is exempted from ethical approval.
Statement of Consent
The patient was informed about the publication and consent was obtained regarding the same.
Publication History
Received: 25 May 2022
Accepted: 18 November 2022
Article published online:
20 January 2023
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References
- 1 Lluch A, Garcia-Elias M. The Sauvé-Kapandji procedure: technical considerations. Orthop Surg Tech 1995; 9: 67-90
- 2 Lluch A. The Sauvé-Kapandji procedure. J Wrist Surg 2013; 2 (01) 33-40
- 3 Rose-Innes AP. Anterior dislocation of the ulna at the inferior radio-ulnar joint. Case report, with a discussion of the anatomy of rotation of the forearm. J Bone Joint Surg Br 1960; 42-B: 515-521
- 4 Brain DA, Fraser JL. Distal radioulnar joint. In: Green's Operative Hand Surgery. Vol 1. 7th ed. Elsevier; 491
- 5 Melone Jr CP, Nathan R. Traumatic disruption of the triangular fibrocartilage complex. Pathoanatomy. Clin Orthop Relat Res 1992; (275) 65-73
- 6 Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. J Hand Surg Am 2000; 25 (03) 464-468
- 7 Bruckner JD, Lichtman DM, Alexander AH. Complex dislocations of the distal radioulnar joint. Recognition and management. Clin Orthop Relat Res 1992; (275) 90-103
- 8 Darrach W. Forward dislocation at the inferior radio-ulnar joint. Ann Surg 1912; 56: 801
- 9 Kikuchi Y, Nakamura T, Horiuchi Y. Irreducible chronic palmar dislocation of the distal radioulnar joint—a case report. Hand Surg 2005; 10 (2-3): 319-322
- 10 Paley D, Rubenstein J, McMurtry RY. Irreducible dislocation of distal radial ulnar joint. Orthop Rev 1986; 15 (04) 228-231
- 11 Lamey DM, Fernandez DL. Results of the modified Sauvé-Kapandji procedure in the treatment of chronic posttraumatic derangement of the distal radioulnar joint. J Bone Joint Surg Am 1998; 80 (12) 1758-1769
- 12 Jupiter JB, Ring D. A comparison of early and late reconstruction of malunited fractures of the distal end of the radius. J Bone Joint Surg Am 1996; 78 (05) 739-748
- 13 Fernandez DL. Radial osteotomy and Bowers arthroplasty for malunited fractures of the distal end of the radius. J Bone Joint Surg Am 1988; 70 (10) 1538-1551