• Title/Summary/Keyword: Radioulnar joint dislocation

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Delayed Diagnosis of Volar Dislocation of the Distal Ulna after Treatment of the Radial Shaft Fracture (요골 간부 골절 치료 후 지연 발견된 원위 척골의 전방 탈구)

  • Jeon, Suk Ha;Lee, Sanglim
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.427-432
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    • 2021
  • Delayed treatment of volar dislocation of the distal radioulnar joint can result in wrist pain, limited rotation of the forearm, and degenerative arthritis that could be managed only by salvage procedures. A 24-year-old male patient presented with wrist pain and a loss of forearm rotation after surgery for a radial shaft fracture. The shaft of the radius was fixed with a plate and screws with a volar angulation of 7°. The ulnar head was dislocated volar to the distal radius, and the bone defect in the ulnar head was impacted into the volar rim of the sigmoid notch of the radius, preventing the head from being reduced in the joint. Corrective osteotomy of the malunited radial shaft and sliding osteotomy of the proximal ulnar head were performed to fill the distal bone defect. Pain and range of the forearm rotation were improved at postoperative 19 months.

A Case Report of Korean Medicine Rehabilitation Treatment after Sauve-Kapandji Procedure (Sauve-Kapandji 수술 후 한방재활치료에 대한 증례보고)

  • Cho, Eun-Byul;Geum, Ji-Hye;Baek, Dong-Gi;Lee, Jung-Han
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.14 no.1
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    • pp.49-59
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    • 2019
  • Objectives : The purpose of this study was to report the clinical progress of a patient exposed to a Sauve-Kapandji procedure after being diagnosed with dislocation of distal radioulnar joint and was treated using Korean medicine rehabilitation treatment. Methods : During the admission period, the patient was treated with acupuncture, cupping, herbal medicine, and Chuna therapy. The clinical progress was assessed by using range of motion(ROM), manual muscle test(MMT), numeric rating scale(NRS), and pain disability index(PDI). Results : After receiving the above treatments, the active ROM and motor grade of the elbow, wrist, and finger joints were improved; the NRS and PDI were decreased. Conclusions : Although this is a single case report, Korean medicine rehabilitation treatment, including Chuna manual therapy, might be an effective intervention for a patient after being exposed to a Sauve-Kapandji procedure.

In vivo 3D Kinematics of Axis of Rotation in Malunited Monteggia Fracture Dislocation

  • Kim, Eugene;Park, Se-Jin;Jeong, Haw-Jae;Ahn, Jin Whan;Shin, Hun-Kyu;Park, Jai Hyung;Lee, Mi Yeon;Tsuyoshi, Murase;Sumika, Ikemototo;Kazuomi, Sugamoto;Choi, Young-Min
    • Clinics in Shoulder and Elbow
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    • v.17 no.1
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    • pp.25-30
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    • 2014
  • Background: Normal elbow joint kinematics has been widely studied in cadaver, whilst in vivo study, especially of the forearm, is rare. Our study analyses, in vivo, the kinematics of normal forearm and of malunited forearm using a three-dimensional computerized simulation system. Methods: We examined 8 patients with malunited Monteggia fracture and 4 controls with normal elbow joint. The ulna and radius were reconstructed from CT data placing the forearm in three different positions; full pronation, neutral, and full supination using computer bone models. We analyzed the axis of rotation 3-dimentionally based on the axes during forearm rotation from full pronation to full supination. Results: Axis of rotation of normal forearm was pitch line, with a mean range of 2 mm, from full pronation to full supination, connecting the radial head center proximally and ulnar fovea distally. In normal forearm, the mean range was 1.32 mm at the proximal radioulnar joint and 1.51 mm at the distal radioulnar joint. However in Monteggia fracture patients, this range changed to 7.65 mm at proximal and 4.99 mm at distal radoulnar joint. Conclusions: During forearm rotation, the axis of rotation was constant in normal elbow joint but unstable in malunited Monteggia fracture patients as seen with radial head instability. Therefore, consideration should be given not only to correcting deformity but also to restoring AOR by 3D kinematics analysis before surgical treatment of such fractures.