Management of Locked Volar Radio-ulnar Joint Dislocation. 2019

Marta Starnoni, and Giulia Colzani, and Giorgio De Santis, and Andrea Leti Acciaro
Division of Plastic Surgery, University of Modena and Reggio Emilia, Largo Pozzo 71, 41124 Modena, Italy.

Isolated volar dislocation of the distal radio-ulnar joint is an extremely rare lesion. Diagnosis is commonly missed. The authors report their experience about a case of an acute locked volar distal radio-ulnar joint dislocation. A correct clinical and radiological diagnosis was done in the Emergency Department, and a closed reduction was achieved only after an axillary block, after a first failed attempt under slight sedation. A K-wire blocking the prono-supination and a short removable forearm cast protected the reduction for 25 days. Two weeks after the removal of the immobilization, the patient presented a complete functional recovery, with full range of motion. The authors highlight the importance of the clinical and radiological findings: a dorsal dimple at the ulnar side leads to a high index of suspicion, and represent the most relevant aid in diagnosis, associated to a proper imaging assessment. Prompt management allows a minimally invasive approach and a rapid functional recovery.

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