Abstract
Radiocarpal dislocations (RCDs) are one of the rare injuries that happen to the wrist in which there is a partial or complete loss of contact between the carpus and distal radius. We present the case of volar RCD in a 25-year-old male patient. He reported to the ED with pain on the wrist of his left forearm. The patient had met with a motor vehicle accident and was put on forearm cast in the previous hospital. Initial clinical examination showed swelling with no visible deformity with good capillary fill; X-ray images showed no fracture, and he was again put on forearm cast giving an orthopedic clinic appointment. A missed diagnosis of left wrist complete volar RCD was found when we reviewed the X-ray, and the patient was called for immediate surgical treatment. He was treated under general anesthesia with closed reduction, and three parallel percutaneous Kirschner wires were pinned to the left radiocarpal joint. Occupational therapy to improve the range of motion and muscle strengthening were done, and clinical follow-up showed improvement in the extension, flexion, and muscle power. The patient was satisfied with the outcome and after three months of follow-up showed no new problems.
Highlights
Radiocarpal dislocations (RCDs) are considered to be one rare type of carpal dislocations. In this type of injury, there is a dislocation of the radiocarpal joint due to partial or complete loss of contact between the carpus and dorsal distal radius that causes a complex ligamentous injury to the carpal instability complex of the wrist [1]
Literature shows that only a few case series have reported cases that included more than 10 RCDs, a case series presented by Dumontier et al that included 27 RCDs was the maximum reported so far [5]
Two days later, when we were reviewing the X-ray imaging in our department, we noticed a missed diagnosis of left wrist joint complete volar RCD, and the patient was called for urgent surgical treatment (Figure 1)
Summary
Radiocarpal dislocations (RCDs) are considered to be one rare type of carpal dislocations. A 25-year-old right-handed electrical technician medically free, came to our ED in Prince Mohammed Bin Abdulaziz National Guard Hospital in Al-Madinah city one week after admission in another hospital because of short time He had loss of consciousness with head trauma, postmotor vehicle accident. Two days later, when we were reviewing the X-ray imaging in our department, we noticed a missed diagnosis of left wrist joint complete volar RCD, and the patient was called for urgent surgical treatment (Figure 1). The patient came to the clinic 12 days postoperation, was doing well without new complaints, the distal neurovascular exam was intact, and new X-ray imaging was good (Figure 4). After three months follow-up, the patient presented without any complication or a new issue with a good range of motion and was discharged from Orthopedic service after evaluating his recent X-ray images (Figures 6-7)
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