Journal List > J Korean Soc Surg Hand > v.21(4) > 1106540

J Korean Soc Surg Hand. 2016 Dec;21(4):225-229. Korean.
Published online December 26, 2016.  https://doi.org/10.12790/jkssh.2016.21.4.225
Copyright © 2016. The Korean Society for Surgery of the Hand
Volar Dislocation of the Distal Radioulnar Joint Blocked by Displaced Dorsal Barton Fracture
Jong Hun Baek,1 Jae Hoon Lee,2 Duke Whan Chung,1 and Young Jun Kim1
1Department of Orthopaedic Surgery, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea.
2Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.

Correspondence to: Jae Hoon Lee. Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea. TEL: +82-2-440-6153, FAX: +82-2-440-7497, Email: ljhos69@naver.com
Received August 11, 2016; Revised September 20, 2016; Accepted October 01, 2016.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Distal radioulnar dislocation is commonly associated with radius fracture. Most common dislocation pattern is the dorsal dislocation. We present the unique case of volar dislocation of the distal radioulnar joint blocked by displaced dorsal Barton fracture of distal radius and discuss the injury mechanism and anatomic lesions.

Keywords: Distal radioulnar joint; Dorsal Barton fracture; Distal radius fracture; Galeazzi fracture

Figures


Fig. 1
Preoperative plain radiographs of left wrist. (A) Anteroposterior and lateral radiographs show displaced dorsal Barton and ulnar styloid process fracture with volar dislocation of the distal radioulnar joint (DRUJ). (B) Computed tomography axial view shows that the size of the displaced bone fragment have involved an area ≥1/2 of the sigmoid notch and the fragment is trans-positioned ulnarly to the DRUJ.
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Fig. 2
Intraoperative photographs, (A) shows ulnarly displaced dorsal Barton fracture. (B) Open reduction and internal fixation were conducted through a dorsal approach.
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Fig. 3
Postoperative anteroposterior and lateral radiographs show internal fixation of dorsal Barton fracture and tension band wiring of unlar styloid process fracture maintaining distal radioulnar joint reduction in anatomic alignment.
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References
1. Mikic ZD. Galeazzi fracture-dislocations. J Bone Joint Surg Am 1975;57:1071–1080.
2. Macule Beneyto F, Arandes Renu JM, Ferreres Claramunt A, Ramon Soler R. Treatment of Galeazzi fracture-dislocations. J Trauma 1994;36:352–355.
3. Itoh Y, Horiuchi Y, Takahashi M, Uchinishi K, Yabe Y. Extensor tendon involvement in Smith's and Galeazzi's fractures. J Hand Surg Am 1987;12:535–540.
4. Magill P, Harrington P. Complex volar dislocation of the distal radioulnar joint in a Galleazi variant associated with interposition of the ulnar neurovascular bundle. Eur J Orthop Surg Traumatol 2009;19:265–267.
5. Werthel JD, Masmejean E, Silvera J, Boyer P, Schlur C. Acute isolated volar dislocation of the distal radio-ulnar joint: case report and literature review. Chir Main 2014;33:364–369.
6. Rose-Innes AP. Anterior dislocation of the ulna at the inferior radio-ulnar joint: case report, with a discussion of the anatomy of rotation of the forearm. J Bone Joint Surg Br 1960;42-B:515–521.
7. Kihara H, Short WH, Werner FW, Fortino MD, Palmer AK. The stabilizing mechanism of the distal radioulnar joint during pronation and supination. J Hand Surg Am 1995;20:930–936.
8. May MM, Lawton JN, Blazar PE. Ulnar styloid fractures associated with distal radius fractures: incidence and implications for distal radioulnar joint instability. J Hand Surg Am 2002;27:965–971.