Abstract
Background Volar dislocations of the distal radioulnar joint (DRUJ) are rare and often missed
during initial evaluation. Chronic dislocations and disability can occur when DRUJ
dislocations are unrecognized and not reduced. DRUJ dislocations often occur with
other wrist injuries, which may complicate reduction. Closed reduction can fail to
reduce DRUJ dislocations, in which case open reduction is necessary.
Case Description This case describes a patient who had a volar dislocation of the DRUJ with an associated
dorsal distal radius fracture dislocation. Initial attempts at closed reduction were
unsuccessful which prompted surgical intervention. After open reduction and internal
fixation of the distal radius fracture dislocation, closed reduction of the DRUJ remained
unsuccessful. This prompted an open reduction of the DRUJ. Surgical exposure demonstrated
that the extensor carpi ulnaris and the distal radius had prevented closed reduction
of the DRUJ. Postoperatively, a splint was placed with the wrist in supination. The
patient followed-up at the 2- and 4-month intervals with persistent subluxation. However,
the patient also reported minimal pain and the ability to return to work and previous
level of activity.
Literature Review Current literature regarding irreducible volar DRUJ dislocations with distal radius
fracture dislocations includes sparse case reports, which are reviewed in this report.
Clinical Relevance This case illustrates successful treatment for an uncommon volar DRUJ dislocation
associated with a dorsal distal radius fracture dislocation and can be utilized to
help guide future treatment of similar complex cases.
Keywords
distal radius - DRUJ - dislocation - irreducible
