Wrist joint-Radiocarpal dislocation – Clinical features, Mechanism, Diagnosis, Treatment , Complications.

1. Clinical features :

1. Swelling.
2. Pain.
3. Numbness and tingling.
4. Deformity around the injured area.

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2. Mechanism :

1. Fall from height.
2. RTA.
3. Falling in hyperextended and pronated wrist.

Others associated conditions can be :

1. Open fractures.
2. Medial nerve injury > Ulnar nerve injury.
3. Distal radius fractures.
4. Ulnar styloid fracture.
5. Carpal bone fracture.
6. Intercarpal injury.

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3. Diagnosis :

1. Plain X-Ray of wrist – AP, lateral and oblique view.
2. Physical appearance.
3. CT scan.
4. MRI is done to evaluate the integrity of the scapholunate and lunotriquetral.

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4. Treatment :

There are mainly two types of treatment methods and they are – Nonoperative and Operative.

A. Non-Operative :

This is done by closed reduction or traction and providing caster slab for 5-6 weeks. This is mainly done when the patient is not medically stable for surgery and chance of getting stable radoiocarpal joint after traction.

B. Operative :

1. Open reduction.
2. Internal fixation.
3. Radiocarpal pinning and ligament repair.

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5. Complications :

1. Malunion.
2. Non union.
3. Stiffness.
4. Acute carpal tunnel syndrome.
5. Post-traumatic arthritis.
6. Chronic radiocarpal instability.
7. Late inter carpal disruption.

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