Ligamentous Radiocarpal Fracture-Dislocation Treated with Wrist-Spanning Plate and Volar Ligament Repair

Abstract

Background Radiocarpal fracture-dislocations are challenging injuries that are often associated with postoperative pain, stiffness, instability, or early arthrosis.

Case Description We report a 1-year follow-up of a ligamentous radiocarpal dislocation (Dumontier group I) treated with a dorsal wrist-spanning plate and volar capsular repair with good results.

Literature Review Historically, Dumontier group I injuries treated with a variety of techniques (closed reduction and casting, percutaneous pinning, and open fixation) have been associated with stiffness and loss of reduction.

Clinical Relevance Distraction plating is a safe and effective technique for treating select distal radius fractures, and we suggest it has the potential to produce good outcomes when used to treat radiocarpal fracture-dislocations.

Keywords

radiocarpal dislocation - wrist dislocation - distraction plating - internal fixation - surgical technique

• References

• 1 Dumontier C, Meyer zu Reckendorf G, Sautet A, Lenoble E, Saffar P, Allieu Y. Radiocarpal dislocations: classification and proposal for treatment. A review of twenty-seven cases. J Bone Joint Surg Am 2001; 83-A (2) 212-218
• 2 Ilyas AM, Mudgal CS. Radiocarpal fracture-dislocations. J Am Acad Orthop Surg 2008; 16 (11) 647-655
• 3 Mudgal CS, Psenica J, Jupiter JB. Radiocarpal fracture-dislocation. J Hand Surg [Br] 1999; 24 (1) 92-98
• 4 Nyquist SR, Stern PJ. Open radiocarpal fracture-dislocations. J Hand Surg Am 1984; 9 (5) 707-710
• 5 Ginn TA, Ruch DS, Yang CC, Hanel DP. Use of a distraction plate for distal radial fractures with metaphyseal and diaphyseal comminution. Surgical technique. J Bone Joint Surg Am 2006; 88 Pt 1 29-36
• 6 Hanel DP, Ruhlman SD, Katolik LI, Allan CH. Complications associated with distraction plate fixation of wrist fractures. Hand Clin 2010; 26 (2) 237-243
• 7 Richard MJ, Katolik LI, Hanel DP, Wartinbee DA, Ruch DS. Distraction plating for the treatment of highly comminuted distal radius fractures in elderly patients. J Hand Surg Am 2012; 37 (5) 948-956
• 8 Ruch DS, Ginn TA, Yang CC, Smith BP, Rushing J, Hanel DP. Use of a distraction plate for distal radial fractures with metaphyseal and diaphyseal comminution. J Bone Joint Surg Am 2005; 87 (5) 945-954
• 9 Brown D, Mulligan MT, Uhl RL. Volar ligament repair for radiocarpal fracture-dislocation. Orthopedics 2013; 36 (6) 463-468
• 10 Oberladstätter J, Arora R, Dallapozza C, Smekal V, Kammerlander C, Lutz M. Radiological radio-carpal and mid-carpal motion after operative treatment of dorsal radio-carpal fracture dislocations. Arch Orthop Trauma Surg 2010; 130 (1) 77-81