Isolated Volar Distal Radioulnar Joint Dislocation, a Very Rare and Easily Missed Injury.

Abstract

Background: Isolated distal radioulnar joint (DRUJ) dislocations without associated fracture are very rare entities. A few mechanisms of injury were reported in the literature with dorsal(posterior) dislocation being more common than the volar (palmar, anterior) dislocation. Case report: A 26-year-old male, manual laborer presented to our emergency department (ED) 24 hours post-self-inflected injury with right wrist pain, deformity, and decreased range of motion (ROM). The physical examination showed bruising over the dorsal ulnar side of the wrist, loss of the ulnar styloid bony prominence, abnormal volar fullness of the wrist, and gutter deformity on the dorsal aspect of the distal forearm and wrist. The diagnosis was confirmed by comparative radiographs which were followed by closed reduction and immobilization in the below-elbow cast in pronation for 4 weeks. Conclusion: Timely accurate diagnosis and conservative treatment with favorable outcome necessitate a proper history on the mechanism of injury with a thorough physical examination, accurate radiographic positioning, and true lateral view.

Keywords

• distal radioulnar
• joint radioulnar
• volar
• conservative treatment