Distal radioulnar joint disruption
Background
- Seen with intra-articular or distal radial shaft fractures or both bone fracture
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
- Radiographic signs of instability:
- Radial shortening
- Fracture of the sigmoid notch of radius
- Fracture of ulnar styloid base with >2mm displacement
- Consider forearm radiographs to evaluate for Galeazzi fracture-dislocation and Essex Lopresti
Differential Diagnosis
Distal radius fractures
- Colles' fracture
- Smith's fracture
- Barton's fracture
- Radial styloid fracture
- Distal radioulnar joint disruption
Distal radius fracture eponyms
| Eponyms | Description |
| Barton's | Fracture-dislocation of radiocarpal joint (with intra-articular fracture involving the volar or dorsal lip) |
| Chauffer's | Fracture of radial styloid |
| Colles' | Dorsally displaced, extra-articular fracture |
| Die-punch | Depressed fracture of the lunate fossa (articular surface) |
| Smith's | Volar displaced, extra-articular fracture |
Management
- Dorsal dislocation
- Immobilize wrist in supination
- Volar dislocation
- Immobilize wrist in pronation
See Also
References
- 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.