Non-surgical Management of an Acute Isolated Volar Dislocation of the Distal Radioulnar Joint.

Abstract

Introduction:Isolated distal radioulnar joint dislocations are rare and commonly missed on radiographs. Knowledge of the management of these injuries, therefore, has room for improvement. We present a case with an alternative method of closed reduction.Case Presentation:A young Caucasian male presented with severe pain and deformity of the left wrist, following a collision while playing rugby. This was easily diagnosed using plain radiographs and the initial attempted reduction methods in the Emergency Department failed. The patient was subsequently anesthetized in theatre, yet reduction by an accepted method of palmar to dorsal pressure over the interosseous membrane with simultaneous distraction of the wrist failed. A further attempt to manipulate the dislocated ulnar head was successful, with the same force applied, while the wrist was maximally flexed and pronated – thereby avoiding an open reduction.Conclusion:This technique has not previously been described in the literature and may be used in similar injuries in the future.