Abstract
Background:Posttraumatic ulnar carpal translocation is a very rare condition that is caused either by fracture-dislocation injury or by purely ligamentous injury of the wrist. Its prognosis is poor and development of posttraumatic pancarpal wrist joint osteoarthritis is inevitable, and options for treatment are total wrist fusion or total wrist arthroplasty.Methods:A 24-year-old male sustained a fracture-related injury in his left wrist that was accompanied with a second ligamentous distorsion-related injury 1 year later in the same wrist. Seven years after first injury, a posttraumatic pancarpal wrist joint osteoarthritis has developed that was caused by posttraumatic ulnar carpal translocation. The patient was treated by total wrist arthroplasty with use of the MaestroTM Wrist Reconstructive System.Results:With our patient, it is unclear whether posttraumatic ulnar carpal translocation occurred either as result of the first fracture-related injury or as result of the second ligamentous distorsion-related injury or as result of both injuries. The 31-year-old patient could be reemployed completely in his original occupation as a mechanic for big agriculture machines and load his wrist with more than 10 pounds. In order to preserve motion, the patient reported that he would undergo the same total wrist arthroplasty a second time were it necessary.Conclusion:We report on a young male receiving total wrist arthroplasty and resulting in good restoration of his high-demand claims in activities of daily living, respectively. However, it cannot be concluded that total wrist arthroplasty is to be preferred generally over total wrist fusion in young patients. Essential prerequisite for this motion-preserving procedure is the compliance of patients.
Highlights
Posttraumatic ulnar carpal translocation (PUCT) is a very rare condition that is caused either by fracture-dislocation injury or by purely ligamentous injury of the wrist mainly involving the volar extrinsic radioscaphocapitate ligament1874-3250/17 2017 Bentham Open440 The Open Orthopaedics Journal, 2017, Volume 11Ingo Schmidt (RSCL)
The diagnosis of PUCT is often delayed, and the outcomes after surgical repair are poor potentially leading to posttraumatic pancarpal wrist joint osteoarthritis (OA)
We report on a 24-year-old male who sustained a possible fracture-dislocation injury in his left wrist, and 1 year later an additional purely ligamentous injury in the same wrist that led to PUCT in a course over 7 years and resulted in a total wrist arthroplasty (TWA) with patient's age of 31 years
Summary
Posttraumatic ulnar carpal translocation (PUCT) is a very rare condition that is caused either by fracture-dislocation injury or by purely ligamentous injury of the wrist mainly involving the volar extrinsic radioscaphocapitate ligament1874-3250/17 2017 Bentham Open440 The Open Orthopaedics Journal, 2017, Volume 11Ingo Schmidt (RSCL). Posttraumatic ulnar carpal translocation (PUCT) is a very rare condition that is caused either by fracture-dislocation injury or by purely ligamentous injury of the wrist mainly involving the volar extrinsic radioscaphocapitate ligament. For treatment of posttraumatic pancarpal wrist joint OA there are 2 options: a total wrist fusion (TWF) or a motion-preserving total wrist arthroplasty (TWA). Both of these procedures have advantages and disadvantages. Posttraumatic ulnar carpal translocation is a very rare condition that is caused either by fracture-dislocation injury or by purely ligamentous injury of the wrist. Its prognosis is poor and development of posttraumatic pancarpal wrist joint osteoarthritis is inevitable, and options for treatment are total wrist fusion or total wrist arthroplasty
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