A Rare Case of Fracture of Radius Associated with Dislocation of Both Distal and Proximal Radio-Ulnar Joint

Paragjyoti Gogoi,Prasanta Sonowal,Arup Kumar Daolagupu,Arun Kumar Sipani,Anshuman Dutta

doi:10.4236/crcm.2014.36082

Abstract

Single bone forearm fractures are usually associated with dislocation of one radio-ulnar joint. The association of ulnar fractures with dislocation of proximal radio-ulnar joint and radius fractures with distal radio-ulnar joint is well described. Classically they are better known as Monteggia and Galeazzi fracture dislocations respectively. These peculiar presentations are attributed to intricate relationship of the forearm bones joined together as a unit by two radio-ulnar joints at proximal and distal ends and the interosseous membrane in the middle part. However, simultaneous dislocation of the both radio-ulnar joints associated with fracture of single bone is a very rare event. Literature search does not reveal a single case of such type. We are presenting here a case of fracture shaft of radius associated with dislocation of both proximal and distal radio-ulnar joints. The patient was managed by open reduction and fixation of the radius by a compression plate and the dislocations were reduced by closed method and stabilized with small K wires.

Highlights

Forearm bones along with two radio-ulnar joints and intervening interosseous membrane works as a single functional unit
In Galeazzi fracture shaft of the radius fracture is associated with dislocation of the distal radio-ulnar joint and in Monteggia fracture the shaft of ulna fracture are found with dislocation of the proximal radio-ulnar joint [1] [2]
The proximal radio-ulnar joint was first stabilized with a 2 mm K-wire inserted from distal humerus into radial head keeping the elbow flexed to 90 degrees (Figure 2) and the DRUJ was stabilized with another 2 mm K-wire from Ulna to Radius keeping the forarm in supination (Figure 3 and Figure 4)

Summary

Introduction

Forearm bones along with two radio-ulnar joints and intervening interosseous membrane works as a single functional unit. (2014) A Rare Case of Fracture of Radius Associated with Dislocation of Both Distal and Proximal Radio-Ulnar Joint. In Galeazzi fracture shaft of the radius fracture is associated with dislocation of the distal radio-ulnar joint and in Monteggia fracture the shaft of ulna fracture are found with dislocation of the proximal radio-ulnar joint [1] [2]. These are commonly found and well studied fracture dislocations of forearm. We searched the English literature but failed to notice similar fracture dislocation, maybe this is the first case of this kind

The Case Report

Discussion

Findings

Conclusion