Radiocarpal dislocation: A retrospective study of 14 patients

Abstract

IntroductionRadiocarpal dislocation (RCD) is defined as total loss of contact between the carpal and radial joint surfaces. The condition is rare, with few published series. The aim of the present study was to assess functional results of RCD surgery, notably without ligament reconstruction. HypothesisFunctional outcome of RCD surgery is satisfactory for everyday use of the wrist. Materials and methodsA retrospective study was performed for the period January 2012 to July 2017. Inclusion criteria comprised: RCD on preoperative X-ray, in adult patients, with a minimum 6months’ follow-up; exclusion criteria comprised: unclosed growth plate, and distal radial epiphyseal fracture with large displacement. RCD type was assessed on Dumontier's classification. Functional results were assessed as postoperative range of wrist motion, grip strength (Jamar®), and QuickDASH and Green-O’Brien (modified by Cooney) functional scores. ResultsFourteen patients were followed up at a mean 31months (range, 7–60months). Three showed type I RCD and 11 type II. All were treated surgically; no ligament sutures were performed. Mean flexion was 63° (range, 20–90°), extension 51° (25–90°), pronation 79° (60–90), supination 80° (50–90), and grip strength 27.9kg (8–40). Mean QuickDASH and modified Green-O’Brien scores were respectively 25.6 (4.54–40.9) and 74 (35–100). DiscussionThe present functional results were satisfactory and comparable to those of the literature, despite no use of radiocarpal ligament suture in type-1 RCD. Level of evidenceIV.