Treatment of dislocation in distal radio-ulnar joint due to malunited distal radio-ulnar fracture - A case report -

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Journal of the Korean Society for Surgery of the Hand 1999;4(2):298-302.
Published online January 1, 1999.

Duck Yun Cho,Jae Hwa Kim,Hwan Kim

원위 요·척골 골절후 부정유합에 의한 원위 요척 관절 탈구의 치료 -1 례 보고-

조덕연,김재화,김환

Abstract

The distal radio-ulnar joint(DRUJ) dislocation can be resulted by malunited colles' fracture, Smith fracture, Galeazzi's fracture, or Essex-Lopresti fracture. Operative treatments of dislocation in DRUJ due to malunited distal radio-ulnar fracture are of four categories, as follows: 1. Those to restore anatomical relationships; that is, reestablish the angle of the distal articular surface of the radius, correct radial shortening, and reduce the prominence of the distal ulna (open wedge radial osteotomy, B/G, and I/F with plate); 2. Those that improve function; complete distal ulnar excision (Darrach resection of the distal ulna), partial distal ulnar excisions (Bowers' hemi-resection interposition arthroplasty technique, Watson's matched distal ulnar resection, Feldon's Wafer distal ulnar resection), or Milch's ulnar cuff resection for preserving DRUJ and TFCC; 3. Arthrodesis of the wrist, or DRUJ fusion with creation of a proximal ulnar pseudoarthrosis (Sauve-Kapandji procedure); and 4. Combinations of these operations. We experienced chronic dislocation in DRUJ after the malunited distal radio-ulnar fracture, so performed ulnar shortening by corrective osteotomy, plate-screw fixation and reduction of DRUJ with temporary transfixation. This technique was simple and preserved the DRUJ and TFCC, so functional outcome was good.

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