Neglected volar distal radioulnar joint dislocation with an associated ulnar styloid fracture: A case report and review of literature.

INTRODUCTION AND IMPORTANCE

Volar distal radioulnar joint (DRUJ) dislocation with an isolated ulnar styloid fracture is considered as a very rare clinical entity. Due to its subtle clinical presentation, patients often presented late. Optimal management is required to prevent functional impairment and improved quality of life.

CASE PRESENTATION

A 51-year-old female presented to our outpatient clinic with neglected volar DRUJ dislocation and isolated ulnar styloid fracture, resulting from a previous injury that was initially misdiagnosed as a wrist sprain approximately four months prior. A plain wrist radiograph and computed tomography scan confirmed the volar DRUJ dislocation and ulnar styloid fracture without any other bony involvement. Surgical intervention was planned, and an open reduction technique was performed, consisting of Kirschner wire stabilization, volar radioulnar ligament plication, and volar capsular repair.

DISCUSSION

The involvement of the component of triangular fibrocartilage complex (TFCC) and joint capsule must be evaluated, as both of this structure plays an important role for long-term DRUJ stabilization. Repair or reconstruction must be attempted if an evidence of tears was observed intraoperatively. Temporary stabilization of the distal radioulnar joint while allowing the repaired tissue to heal can be achieved with radioulnar K-wire fixation.

CONCLUSION

Our report suggests that this condition can be managed with a radioulnar K-wire stabilization in combination with a soft tissue repair or reconstruction. This approach was found to resulted in satisfactory clinical outcomes.