Distal Radioulnar Joint Subluxation

Distal Radioulnar Subluxation

The distal radioulnar joint is the joint at the wrist, between the radius and the ulna, the two forearm bones. This injury is usually a subluxation, or a partial dislocation, although fractures of either bone can be involved. It is often caused by a direct impact like a fall, and medical help is needed immediately to check and treat the wrist injury.

Symptoms of distal radioulnar joint subluxations

Symptoms include pain in the wrist after a specific impact or trauma. There will be an increased pain when turning the hand over as the radius and ulna bones rotate. The wrist will usually appear deformed and the ulna is more prominent. The wrist may appear narrower than the other one. There is likely to be swelling and tenderness when pressing in on the wrist.

Causes

The most common cause of a radioulnar joint dislocation is a fall onto an outstretched hand. It may also occur following a force to the hand or wrist which either oversupinates (turns the palm of the hand up) or overpronates (turns the palm down).

Isolated dislocations are most likely to occur from hyperpronation or hypersupination injuries. A fall on to the outstretched hand is more likely to occur in conjunction with fractures to either or both of the bones.

Treatment

If a wrist dislocation is suspected, seek medical attention immediately. An X-ray will be used to confirm the diagnosis and to check for any fractures. Simple dislocations are usually quite straightforward to reduce (put back into place). The wrist and forearm should then be immobilised for 6 weeks to allow all soft tissues to heal.

A rehabilitation program will then be required to regain full wrist movement and strength. For more complex dislocations, surgery may be necessary to reduce the bones and pin any fractures, holding the bones in place whilst they heal. Again the joint is immobilized before a rehabilitation program is commenced.

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