View source for Distal radioulnar joint disruption

==Background==
*Seen with intra-articular or [[distal radius fractures|distal radial shaft fractures]] or [[Radia ulna fracture|both bone fracture]]

==Clinical Features==
*Easy to miss due to concomitant injuries
*Painful pronation or supination of wrist/forearm, possible crepitus
*Prominent or displaced ulnar styloid

==Differential Diagnosis==
{{Distal radius fracture DDX}}

==Evaluation==
===Imaging===
*PA
**Narrowing and overlap of distal radioulnar joint
*Lateral
**Volar or dorsal displacement of ulna (which is usually centered/overlapping the radius)
**Requires a true lateral to avoid a false positive result
*Consider forearm radiographs to evaluate for [[Galeazzi fracture-dislocation]] and [[Essex Lopresti]]

===Radiographic signs of instability<ref name="Hand and wrist emergencies">German C. Hand and wrist emergencies. In: Bond M, ed. Orthopedic Emergencies: Expert Management for the Emergency Physician. Cambridge: Cambridge University Press; October 31, 2013.</ref>===
*Radial shortening
*Fracture of the sigmoid notch of radius
*Fracture of ulnar styloid base with >2mm displacement

==Management==
*Dorsal dislocation
**Immobilize wrist in supination
*Volar dislocation
**Immobilize wrist in pronation

==Disposition==
*Outpatient with ortho followup

==See Also==
*[[Distal radius fractures]]

==References==
<references/>

[[Category:Orthopedics]]