Die radiokarpale Luxationsfraktur

Abstract

Radiocarpal fracture dislocation is a very rare, often complex injury and the result of high energy trauma. We present a retrospective review of four patients. The injury in our series was characterized by a complete dorsal dislocation of the radiocarpal joint with fracture of the radial styloid, associated with avulsion of the palmar and dorsal cortical margin of the distal radius (radiotriquetral ligament included). One case presented a die punch fracture, another case a partial lesion of the scapholunate ligament. All injuries were immediately treated by closed reduction in local anaesthesia. All patients underwent operative treatment with a dorsal approach within seven days. The radial styloid was fixed with screws or Kirschner-wire, the impaction of the dorsoulnar aspect of the radius with elevation and fixation with a 2.7 mm plate. The tear of the scapholunate ligament was sutured and stabilized with Kirschner-wire between scaphoid and lunatum. All wrists were immobilized with a forearm cast for four weeks. The mean follow-up was 25 months. At the time of follow-up all patients showed a very good functional outcome, although the radiographic analysis revealed some osteoarthrotic changes.