Treatment of distal radioulnar joint dislocation

Joint dislocations are diseases that cause obvious pain. Inappropriate handling or treatment of many patients may aggravate the condition or delay recovery. The distal radioulnar joint is a joint that is more prone to dislocation, but it is not easy to detect. An inexperienced doctor may not be able to find it.

1 Causes

This injury can be caused by a sprain of the wrist or by stress from lifting a heavy object, radial deviation, dorsiflexion, or rotation of the wrist.

2 Clinical manifestations

The most common dislocation is the dorsal dislocation of the radioulnar joint. The ulnar head protrudes dorsally when the forearm is pronated, and automatically repositions when it is supinated. There is local swelling and tenderness. Passive movement of the distal radioulnar joint can feel looseness on the normal side, accompanied by pain and sometimes clicking.

3. Inspection

X-ray examination should be performed with bilateral comparison to facilitate observation and judgment.

4 Diagnosis

1. Wrist pain is localized to the distal radioulnar joint and ulnar styloid process, and is aggravated by rotation and ulnar deviation.

2. Comparing the elastic bulge with the healthy side, it can be seen that the head of the ulna bulges toward the dorsal or palmar side. It can be restored by pressing and bounces back to its original position when the hand is raised.

3. Limited movement. Due to the pain, the rotation and ulnar deviation of the forearm on the affected side are significantly limited, especially when accompanied by triangular cartilage injury.

4. The swelling is generally mild.

5. X-ray films should be compared bilaterally to facilitate observation and judgment.

5 Treatment

1. Conservative treatment

(1) Manual reduction is relatively simple and effective in treating fresh distal radioulnar joint dislocation, and conservative treatment is recommended in the early stages. The patient was placed in a supine or sitting position, and the shoulder was abducted 90° under anesthesia for countertraction.

(2) External fixation method uses an elbow-length "U"-shaped plaster splint.

2. Surgery

For patients with severe fracture displacement and wrist ligament tear, conservative treatment and old dislocation, surgical treatment should be considered to restore the corresponding anatomical relationship of the distal radioulnar joint.

There are two ways to treat the distal radioulnar joint, conservative treatment and surgical treatment. If the situation is relatively mild and only requires slight adjustments and rest for a period of time, then choose conservative treatment. If the situation is more serious, then choose surgical treatment, and be careful not to use your hands at will, so as to avoid difficulty in healing the wound.