Alexander A H
Clin Orthop Relat Res. 1977 Nov-Dec(129):238-44. doi: 10.1097/00003086-197711000-00035.
Bilateral dislocation of the distal radioulnar joint seems not to have been reported in the literature. This is a report of a 22-year-old man successfully treated with closed reduction and immobilization in long arm casts. Limited forearm rotation and wrist pain after a twisting injury are typical findings. In ulna dorsal dislocation the patient's forearm is locked in pronation. In ulna volar dislocation the wrist appears narrow and the forearm is locked in supination. The mechanism of injury for dorsal dislocations is hyperpronation; for volar dislocations it is hypersupination. Dislocation of the distal radioulnar joint injures the triangular disk and/or fractures the ulnar styloid. Suspicion is important in making the diagnosis. Fifty per cent of unilateral cases reported in the literature were missed initially or were diagnosed late. The acute case is easily treated by closed reduction under local anesthesia and immobilization in a long arm cast. Treatment of the chronic dislocation includes various soft tissue reconstructions or resection of the distal ulna depending on the degree of arthrosis.
文献中似乎尚未报道过双侧桡尺远侧关节脱位。本文报告了一名22岁男性患者，通过闭合复位及长臂石膏固定成功治愈。扭伤后前臂旋转受限和腕部疼痛是典型表现。尺骨背侧脱位时，患者前臂固定于旋前位；尺骨掌侧脱位时，腕部显得狭窄，前臂固定于旋后位。背侧脱位的损伤机制为过度旋前；掌侧脱位的损伤机制为过度旋后。桡尺远侧关节脱位会损伤三角纤维软骨盘和/或导致尺骨茎突骨折。诊断时保持怀疑态度很重要。文献报道的单侧病例中，有50%最初被漏诊或诊断较晚。急性病例通过局部麻醉下的闭合复位及长臂石膏固定很容易治疗。慢性脱位的治疗包括根据关节病的程度进行各种软组织重建或尺骨远端切除术。
