# Neglected volar distal radioulnar joint dislocation with an associated ulnar styloid fracture: A case report and review of literature

## TL;DR

This case report describes a rare wrist injury involving a dislocated joint and a fractured bone, managed through surgical techniques to restore function.

## Contribution

The paper presents a rare case and emphasizes the importance of evaluating and repairing soft tissues during surgery for long-term joint stability.

## Key findings

- Volar DRUJ dislocation with an isolated ulnar styloid fracture is a rare clinical condition.
- Surgical techniques like K-wire fixation and soft tissue repair can lead to satisfactory outcomes.
- Intraoperative evaluation of TFCC and joint capsule is essential for long-term joint stability.

## Abstract

Volar distal radioulnar joint (DRUJ) dislocation with an isolated ulnar styloid fracture is considered as a very rare clinical entity. Due to its subtle clinical presentation, patients often presented late. Optimal management is required to prevent functional impairment and improved quality of life.

A 51-year-old female presented to our outpatient clinic with neglected volar DRUJ dislocation and isolated ulnar styloid fracture, resulting from a previous injury that was initially misdiagnosed as a wrist sprain approximately four months prior. A plain wrist radiograph and computed tomography scan confirmed the volar DRUJ dislocation and ulnar styloid fracture without any other bony involvement. Surgical intervention was planned, and an open reduction technique was performed, consisting of Kirschner wire stabilization, volar radioulnar ligament plication, and volar capsular repair.

The involvement of the component of triangular fibrocartilage complex (TFCC) and joint capsule must be evaluated, as both of this structure plays an important role for long-term DRUJ stabilization. Repair or reconstruction must be attempted if an evidence of tears was observed intraoperatively. Temporary stabilization of the distal radioulnar joint while allowing the repaired tissue to heal can be achieved with radioulnar K-wire fixation.

Our report suggests that this condition can be managed with a radioulnar K-wire stabilization in combination with a soft tissue repair or reconstruction. This approach was found to resulted in satisfactory clinical outcomes.

•Volar DRUJ dislocation with an associated ulnar styloid fracture is a very rare clinical entity.•Involvement of TFCC and joint capsule should be address intraoperatively.•K-wire fixation on the radioulnar was intended to temporarily stabilize and restore the radioulnar association.•Repair or reconstruction must be performed to ensure long-term DRUJ stability if involvement of TFCC or capsule was observed.

Volar DRUJ dislocation with an associated ulnar styloid fracture is a very rare clinical entity.

Involvement of TFCC and joint capsule should be address intraoperatively.

K-wire fixation on the radioulnar was intended to temporarily stabilize and restore the radioulnar association.

Repair or reconstruction must be performed to ensure long-term DRUJ stability if involvement of TFCC or capsule was observed.