Radiocarpal Fracture Dislocations: A Retrospective Review on Operative Fixation and Postoperative Range of Motion.

BACKGROUND: Radiocarpal dislocation (RCD) and radiocarpal fracture dislocation (RCFD) are rare but severe injury patterns with multiple types of fixation techniques described. The purpose of this study was to determine the outcomes of RCD and RCDF treated at our institution. METHODS: Patients were identified using our institution's electronic medical records between 2013 and 2022. Seventeen patients met criteria who suffered either RCD or RCFD. Patient charts were reviewed retrospectively with a focus on demographics, mechanism of injury, smoking status, open injury, direction of dislocation, Moneim and Dumontier classification, procedures, complications, final range of motion and subsequent surgeries. RESULTS: Seventeen patients met criteria with an average age of 38.5 years. Thirteen patients sustained dorsal dislocations while 4 sustained volar dislocations. Four were Dumontier type I and 13 were type II. Twelve were Moneim type I and 5 were type II. Fourteen of the 17 patients had at least 6-month follow-up. The average flexion and extension at time of last follow-up was 33.6° and 39.5°, respectively. Average pronation and supination was 80.6° and 63.1°, respectively. Fourteen patients underwent subsequent surgeries, mainly hardware removal, and 5 had complications resulting in unplanned return to the operating room. There was no significant difference in post operative range of motion, complications, or subsequent surgeries based on Moneim or Dumontier classification (P > 0.11). CONCLUSIONS: Radiocarpal dislocation and RCFD are challenging and rare injuries with multiple patterns and variance. With proper fixation and recognition of associated injuries, patients with these injuries can expect to return to work and achieve functional range of motion.

Dorsal Radiocarpal Dislocation with Radial Styloid Fracture Treated with Arthroscopy-Assisted Reduction and Internal Fixation: A Report of Two Cases.

Radiocarpal dislocation is an uncommon injury that is usually caused by high-energy trauma. Herein, we present two cases of dorsal radiocarpal dislocation with radial styloid fractures that were treated by arthroscopy-assisted reduction and internal fixation. Wrist arthroscopy provides accurate information on intra-articular fractures and carpal and/or intracarpal ligamentous tears of the radiocarpal joint. Furthermore, the procedure enables simultaneous anatomical reduction of intra-articular fractures and radiocarpal and/or intercarpal ligament repair. Arthroscopy-assisted reduction and internal fixation yield satisfactory outcomes for patients presenting with dorsal radiocarpal dislocation and radial styloid fractures.

Combined Radiocarpal Dislocation and Forearm Joint Injuries: A Proposed Modification of the Locker-Based Classification System.

The comprehensive locker-based classification system brought revolutionary insight into the treatment of often misdiagnosed forearm joint injuries. The authors of the classification scheme subsequently described a combination of simple elbow dislocations and forearm joint injuries (two- and three-locker injuries), but to date, no review of the literature on combined radiocarpal dislocation and forearm joint injuries has been undertaken. The combination of radiocarpal dislocation and forearm joint injury is a rare traumatic pattern, usually related to high-energy trauma. The aim of this study was to confirm the possible occurrence of a forearm joint injury and radiocarpal dislocation. We performed a systematic review of the existing literature, including case reports, to find combinations of radiocarpal dislocation and forearm joint injury. Only one case report was found. Based on the results of our search and the literature review, we recommend modifying the comprehensive locker-based classification system by adding injury patterns of combined forearm joint and neighboring joint injuries.

Pure traumatic unstable radiocarpal dislocation over pre-existing ulnar impingement syndrome, extensively arched carpus and medially rotated scaphoid: An exceptional and complex case report.

Introduction and importance: Radiocarpal dislocation is a rare and severe injury that demands urgent diagnosis and treatment. In this case report, we present the unique scenario of a 32-year-old male who suffered a traumatic pure unstable radiocarpal dislocation. This dislocation was associated with ulnar impingement syndrome, an extensively arched carpus, and a medially rotated scaphoid. The complexity of this injury underscores the importance of timely intervention and comprehensive management. Case presentation: The patient had a pre-existing short ulnar head with radial-sided deformity, radioulnar convergence, negative ulnar variance, erosive scalloping of the distal radius, subchondral sclerosis of the ulnar head, scapholunate diastasis, and distal radioulnar joint (DRUJ) diastasis. Following a high-velocity motor vehicle accident, the initial treatment involved closed reduction and radio-metacarpal external fixation. Additionally, surgical intervention was required for an open dislocation of the metatarsophalangeal (MTP) joint of the left hallux. Clinical discussion: The subsequent management of this complex case included the Sauvé-Kapandji procedure, ulnolunate and ulnotriquetral ligamentoplasty using the palmaris longus tendon, and scapholunate fusion. The patient reported no prior wrist instability or injury upon awakening, but mild mechanical wrist pain persisted after exertion. Follow-up assessments revealed residual pain during prono-supination, along with slightly limited radial inclination. This exceptional case highlights the biomechanical challenges and the need for a multidisciplinary approach in treating such injuries. Conclusion: To the best of our knowledge, this is the first documented instance of a traumatic pure unstable radiocarpal dislocation associated with ulnar impingement syndrome, an extensively arched carpus, and a medially rotated scaphoid. Despite the complexity, proper bone healing and favorable functional outcomes were achieved through meticulous surgical management. This case underscores the importance of individualized treatment strategies for rare and challenging wrist injuries.

Bridge plating in the setting of radiocarpal instability: Does distal fixation to the second or third metacarpal matter? A cadaveric study.

BACKGROUND: Radiocarpal dislocations are rare but potentially devastating injuries. Poorer outcomes are associated with inadequate or lost reduction, such as ulnar translocation, but no consensus exists on the ideal fixation technique. Dorsal bridge plate fixation has been described for various settings in the treatment of complex distal radius fractures and can be fixed distally to the second or third metacarpal, but its application for radiocarpal dislocations has not been established. AIM: To determine whether distal fixation to the second or third metacarpal matters. METHODS: Using a cadaveric radiocarpal dislocation model, the effect of distal fixation was studied in two stages: (1) A pilot study that investigated the effect of distal fixation alone; and (2) a more refined study that investigated the effect of described techniques for distal and proximal fixation. Radiographs were measured in various parameters to determine the quality of the reduction achieved. RESULTS: The pilot study found that focusing on distal fixation alone without changing proximal fixation results in ulnar translocation and volar subluxation when fixing distally to the second metacarpal compared with the third. The second iteration demonstrated that anatomic alignment in coronal and sagittal planes could be achieved with each technique. CONCLUSION: In a cadaveric radiocarpal dislocation model, anatomic alignment can be maintained with bridge plate fixation to the second metacarpal or the third metacarpal if the described technique is followed. When considering dorsal bridge plate fixation for radiocarpal dislocations, the surgeon is encouraged to understand the nuances of different fixation techniques and how implant design features may influence proximal placement.

Volar Radiocarpal Ligament Repair with Suture Anchors for Radiocarpal Fracture Dislocations: Case Series.

Background Radiocarpal fracture dislocations cause significant intraarticular disruption and instability difficult to treat with traditional plating methods. Description of Technique Suture anchor fixation of the volar radiocarpal ligaments through an extended carpal tunnel approach, supplemented with radial styloid fixation, restores stability to the radiocarpal joint. Patients and Methods We performed a retrospective review of 14 consecutive radiocarpal fracture-dislocations (RCFDs) treated at two-level one trauma center from 2011 to 2015. In all cases, the volar radiocarpal ligaments were repaired to the distal radius with suture anchors. Results We reviewed 14 Dumontier Group 2 RCFDs in 14 patients (10 males, four females) with an average age of 39 years (range 22-53 years). Final follow-up averaged 288 days (range 7-1,364 days). Surgeons performed volar ligament repair with suture anchors in all cases, radial styloid fixation in 79% (11/14), and dorsal plate fixation in 29% (4/14). Eight of 14 patients (57%) had a "flipped" volar lip fragment of the distal radius. Three patients had forearm compartment syndrome and two patients had acute carpal tunnel syndrome. No patients experienced radiocarpal subluxation after volar ligament repair. Conclusion No recurrent subluxation or dislocation occurred after primary repair of the volar radiocarpal ligaments using suture anchors in this series of radiocarpal fracture dislocations. Volar radiocarpal ligament repair also addressed the "flipped" volar rim fragment that could not be addressed through a dorsal approach alone. Level of Evidence : This is a Level IV, case series therapeutic study.

Transstyloid radiocarpal dislocation: A case report.

INTRODUCTION AND IMPORTANCE: Transstyloid radiocarpal dislocation is a rare injury. It is due to high-energy trauma. It usually associates a radiocarpal dislocation, a fracture of the radial and/or cubital styloid process, and a cortical volar/dorsal margin avulsion. CASE PRESENTATION: We present a case of a 31-year-old male who sustained a fell from a 4 m height causing a transstyloid radiocarpal dislocation. He was treated with a radial styloid process pinning and wrist arthrorisis with and splint immobilization. CLINICAL DISCUSSION: Different treatment options can be available for this type of injury with or without ligaments reconstruction. CONCLUSION: Although it is rare, the transstyloid radiocarpal dislocation has a good outcome with different types of treatment.

Wrist-Spanning Fixation of Radiocarpal Dislocation: A Cadaveric Assessment of Ulnar Translation.

Background: Radiocarpal dislocations represent a high-energy wrist injury that can occur with or without concomitant fractures about the wrist. Poor outcomes are often due to radiocarpal instability and secondary ulnar translation. The purpose of this cadaveric study is to determine if there is any difference in the radiographic parameters in a wrist dislocation model given the different location of distal fixation. Methods: Ten paired fresh cadaver upper extremities were fluoroscopically evaluated with posterior-anterior (PA) and lateral views. We created a radiocarpal dislocation model and applied a dorsal bridge plate to either the second or third metacarpal. Repeat PA and lateral fluoroscopic views were obtained for evaluation of radial inclination, radial height, volar tilt, ulnar variance, radiolunate angle, radioscaphoid angle, scapholunate angle, radial rotation index, and four indices for ulnar translation (Taleisnik, Gilula, McMurtry, and Chamay). Results: Bridge plate application to the second metacarpal resulted in a significantly greater incidence of ulnar translation compared to the third metacarpal. Application to either metacarpal resulted in extension of the carpus relative to the radius. Conclusions: A more anatomic radiocarpal relationship was restored more often when distal fixation of the dorsal wrist-spanning bridge plate was applied to the third metacarpal. Further investigation is warranted to determine clinical relevance of these findings in conjunction with clinical and radiographic outcomes.

Volar Radiocarpal Dislocation: A Case Report and Review of Literature.

Radiocarpal dislocations (RCDs) are one of the rare injuries that happen to the wrist in which there is a partial or complete loss of contact between the carpus and distal radius. We present the case of volar RCD in a 25-year-old male patient. He reported to the ED with pain on the wrist of his left forearm. The patient had met with a motor vehicle accident and was put on forearm cast in the previous hospital. Initial clinical examination showed swelling with no visible deformity with good capillary fill; X-ray images showed no fracture, and he was again put on forearm cast giving an orthopedic clinic appointment. A missed diagnosis of left wrist complete volar RCD was found when we reviewed the X-ray, and the patient was called for immediate surgical treatment. He was treated under general anesthesia with closed reduction, and three parallel percutaneous Kirschner wires were pinned to the left radiocarpal joint. Occupational therapy to improve the range of motion and muscle strengthening were done, and clinical follow-up showed improvement in the extension, flexion, and muscle power. The patient was satisfied with the outcome and after three months of follow-up showed no new problems.

Perilunate Injury with Concomitant Short Radiolunate Ligament Disruption: Prevalence and Surgical Outcomes-"An Unusual Perilunate Injury Variant".

Background In the classic description of perilunate injuries, the short radiolunate ligament (SRL) remains intact. Objective This study was aimed to determine the occurrence of SRL disruptions with perilunate injuries and review the clinical and radiographic outcomes after surgical management. Patients and Methods A retrospective review was conducted for patients who sustained a perilunate injury and a concomitant disruption of the SRL at a single-level-1 trauma center between January 2013 and January 2017. Patients with the combined injury pattern were compared with those with perilunate injury alone without SRL injury during the study period. Outcome measures included pain scores (visual analogue score), wrist and forearm range of motion, patient's return to their former occupation, and multiple radiographic parameters. Results Twenty-seven patients were treated operatively for a perilunate injury. Eight of these patients (30%) were found to have associated disruption of the SRL. When compared with patients with perilunate injury alone, these patients had a lower rate of return to work (57% [4 of 7] vs. 92% [12 of 13]), a significantly longer mean length of time to return to work (5.9 vs. 3.8 months), and a higher rate of associated upper extremity injury (75% [3 of 8] vs. 16% [3 of 19]. Conclusion Combined SRL disruption and perilunate dislocation or fracture dislocation represent a high-energy variant from the classic description of a perilunate injury. A heightened awareness for this combined injury pattern should be maintained when treating patients with perilunate injuries. Level of Evidence This is a Level III, prognostic study.

Dorsal fracture-dislocation of the radiocarpal joint: a new classification and implications in surgical treatment.

Dorsal dislocations and fracture-dislocations of the radiocarpal joint are a spectrum of pathology involving both the bony and ligamentous structures that stabilize the radiocarpal joint. We retrospectively reviewed 63 dorsal radiocarpal dislocations treated in our Institute in order to propose a new classification and define surgical treatment. Preoperative CT-scan findings together with clinical and radiological outcomes were recorded. We identified four main types of lesions: Type I, pure dorsal radiocarpal dislocation; Type IIA, dorsal wall impaction and radial styloid avulsion; Type IIB, as IIA with additional intra-articular die punch; Type III, volar and dorsal marginal fragments; Type IV, larger volar and dorsal fragments. For each type of lesion, we propose specific options for treatment that are progressively more invasive. We believe that this classification adequately addresses the whole spectrum of bony and soft tissue injuries that occurs in dorsal radiocarpal fracture-dislocations giving a practical guide for surgical treatment.Level of evidence: IV.

Radiocarpal dislocation: A retrospective study of 14 patients.

INTRODUCTION: Radiocarpal dislocation (RCD) is defined as total loss of contact between the carpal and radial joint surfaces. The condition is rare, with few published series. The aim of the present study was to assess functional results of RCD surgery, notably without ligament reconstruction. HYPOTHESIS: Functional outcome of RCD surgery is satisfactory for everyday use of the wrist. MATERIALS AND METHODS: A retrospective study was performed for the period January 2012 to July 2017. Inclusion criteria comprised: RCD on preoperative X-ray, in adult patients, with a minimum 6months' follow-up; exclusion criteria comprised: unclosed growth plate, and distal radial epiphyseal fracture with large displacement. RCD type was assessed on Dumontier's classification. Functional results were assessed as postoperative range of wrist motion, grip strength (Jamar®), and QuickDASH and Green-O'Brien (modified by Cooney) functional scores. RESULTS: Fourteen patients were followed up at a mean 31months (range, 7-60months). Three showed type I RCD and 11 type II. All were treated surgically; no ligament sutures were performed. Mean flexion was 63° (range, 20-90°), extension 51° (25-90°), pronation 79° (60-90), supination 80° (50-90), and grip strength 27.9kg (8-40). Mean QuickDASH and modified Green-O'Brien scores were respectively 25.6 (4.54-40.9) and 74 (35-100). DISCUSSION: The present functional results were satisfactory and comparable to those of the literature, despite no use of radiocarpal ligament suture in type-1 RCD. LEVEL OF EVIDENCE: IV.

Hook Plate for Volar Rim Fractures of the Distal Radius: Review of the First 23 Cases and Focus on Dorsal Radiocarpal Dislocation.

Background Fragment-specific fixation of the distal radius is born to fix each articular fragment with limited surgical approach and low-profile devices. Over time, many devices with different designs and characteristics have been developed. However, many of them have showed the inability to securely fix marginal, small, and comminuted fragments as bony ligament avulsions and bony compression injuries. Purpose The purpose of this study was to evaluate the clinical and radiological outcome of a new device born to treat marginal articular fractures of the distal radius. Patients and Methods A retrospective review was conducted on 23 patients with a mean follow-up of 21 months including postoperative clinical evaluation, grip strength, computed tomography scan, and X-ray control. Results All fragments healed and maintained reduced until the final follow-up. The carpus was aligned with the distal radius in all patients presenting with a radiocarpal dislocation. Conclusion The volar rim fragment is an attachment site for the short radiolunate and the volar distal radioulnar ligament. Its unstable fixation can lead to articular incongruity, volar or dorsal subluxation of the carpus, and distal radioulnar instability. The involvement of this fragment on distal radius fractures is relatively common and many studies of the literature have been focused on its treatment. The Hook Plate stabilizes distal fragments at their bone-ligament interface. In addition to bony reduction, the device permits to stabilize the capsule and ligaments, as volar bony ligament avulsions, in a picture of dorsal radiocarpal dislocation. Level of Evidence This is a Level IV, case series.

Radiocarpal dislocations and fracture-dislocations: Injury types and long-term outcomes.

INTRODUCTION: Radiocarpal dislocation (RCD) and fracture-dislocations (RCFD) are severe but rare injuries for which the treatment and outcomes are not well defined. The aim of this retrospective study was to describe the prevalence of the various injury types and their long-term outcomes. PATIENTS AND METHODS: Between 1992 and 2014, 41 patients with RCFD were seen at our institution. According to the Dumontier classification, there were 4 cases of type 1 and 37 cases of type 2. Thirteen patients were reviewed again after a mean follow-up of 168 months (20-260). RESULTS: Among these 41 patients, 6 required secondary wrist fusion. At the latest follow-up evaluation, flexion-extension amplitude was 100° (25°-152°), grip strength was 86% of the contralateral side (10kgf-112kgf), the mean VAS for pain was 1.3 (0-5), the mean QuickDASH was 23 (0-59) and the mean PWRE was 27 (0-75). Six patients developed osteoarthritis in the radiocarpal and midcarpal joints. DISCUSSION: For cases of RCD, when reduction and stabilization have been confirmed by a dorsal approach, there is no reason to perform volar capsule and ligament suturing. For cases of RCFD, after anatomical reduction, radiostyloid pinning can be performed and an open surgical approach is not always required. Radiolunate fusion is a good solution for treating secondary instability. CONCLUSION: The good functional outcomes and absence of osteoarthritis can be attributed to the effective reduction and radiocarpal stabilization, along with the absence of radial and intracarpal marginal fractures. LEVEL OF EVIDENCE: IV, retrospective.

A Stepwise Approach to Management of Open Radiocarpal Fracture-Dislocations: A Case Report.

Radiocarpal dislocations are uncommon and occur after significant trauma. We describe a unique case of open radiocarpal fracture-dislocation presenting with progressive neurovascular compromise. Staged management was necessary. As a first stage, emergent provisional bedside reduction in the emergency room with manual pressure through the open wounds was performed. The second stage then involved formal open reduction and internal fixation as soon as operating room staff and resources became available.

Does Total Wrist Arthroplasty for Treatment of Posttraumatic Wrist Joint Osteoarthritis in Young Patients Always Lead to Restriction of High-demand Activities of Daily Living? Case Report and Brief Review of Recent Literature.

BACKGROUND: Posttraumatic ulnar carpal translocation is a very rare condition that is caused either by fracture-dislocation injury or by purely ligamentous injury of the wrist. Its prognosis is poor and development of posttraumatic pancarpal wrist joint osteoarthritis is inevitable, and options for treatment are total wrist fusion or total wrist arthroplasty. METHODS: A 24-year-old male sustained a fracture-related injury in his left wrist that was accompanied with a second ligamentous distorsion-related injury 1 year later in the same wrist. Seven years after first injury, a posttraumatic pancarpal wrist joint osteoarthritis has developed that was caused by posttraumatic ulnar carpal translocation. The patient was treated by total wrist arthroplasty with use of the MaestroTM Wrist Reconstructive System. RESULTS: With our patient, it is unclear whether posttraumatic ulnar carpal translocation occurred either as result of the first fracture-related injury or as result of the second ligamentous distorsion-related injury or as result of both injuries. The 31-year-old patient could be reemployed completely in his original occupation as a mechanic for big agriculture machines and load his wrist with more than 10 pounds. In order to preserve motion, the patient reported that he would undergo the same total wrist arthroplasty a second time were it necessary. CONCLUSION: We report on a young male receiving total wrist arthroplasty and resulting in good restoration of his high-demand claims in activities of daily living, respectively. However, it cannot be concluded that total wrist arthroplasty is to be preferred generally over total wrist fusion in young patients. Essential prerequisite for this motion-preserving procedure is the compliance of patients.

High-energy injuries of the wrist.

High-energy injuries to the wrist gather complex fractures of the distal radius, radiocarpal dislocations, perilunate dislocations, and other intracarpal dislocations. Depending on the energy of the injury and the position of the wrist at the time of impact, the patient, often a young male with a high functional demand, presents one of these injuries associating fracture(s) and ligament injury. The trauma is often bilateral, with proximal lesions (elbow) very often associated with contusion or compression of the median nerve. Diagnosis is confirmed by wrist X-rays, which are sufficient to determine treatment for radiocarpal and perilunate dislocations. In cases of distal radius fractures or other intracarpal dislocations, a preoperative CT is necessary. Reduction of the dislocation and relief of neurovascular compression are performed immediately. The final treatment of each lesion (bone fixation, ligament repair) can be undertaken simultaneously or delayed, depending on the patient and the lesions. Cartilage lesions, resulting from the high-energy injury, can be estimated using arthroscopy but cannot be repaired and determine the prognosis. The surgeon's objective is to restore joint congruence, which does not prevent stiffness, the main complication of these rare injuries, which the surgeon must know how to recognize and treat.

Open volar radiocarpal dislocation with extensive dorsal ligament and extensor tendon damage: A case report and review of literature.

The authors present the case of a patient with a rare combination of open volar radiocarpal dislocation and complete destruction of the dorsal capsule-ligament complex and tendons. The treatment consisted of open reduction and arthrorisis (temporary arthrodesis during 45 days) with four K-wires (radiocarpal and radioulnar). The capsule-ligament complex was fixed with anchors and the extensor tendons were repaired by suturing. A long-arm cast was applied for six weeks. After an 18-month follow-up, the Cooney-modified Green and O'Brien score was 70 and the wrist range of motion was 85°. Dynamic intraoperative X-rays are needed to look for bone or ligament (intracarpal or radioulnocarpal) injuries. Arthrography, arthroscopy or MRI may provide additional information. In cases of stable lesions without intracarpal ligament injuries, conservative treatment may be sufficient. Otherwise, surgical treatment is required, using temporary external fixation or arthrorisis (temporary arthrodesis) associated with anatomic repair of capsular ligaments. The average duration of postoperative immobilization is 6.6 weeks. An external fixator seems to be useful for reduction and for placing optimal tension on repaired ligament repair. Twenty-three cases of volar radiocarpal dislocation are described in published studies. None of them was associated with bone, tendon, skin or capsule-ligament complex injuries. Few studies describe the long-term functional and radiological outcomes of these injuries.

Outcomes after radiocarpal dislocation: a retrospective review.

BACKGROUND: Radiocarpal dislocations are rare, high-energy injuries. High morbidity and poor functional outcomes are common. Currently, there is limited data on functional outcomes following treatment of this injury. METHODS: A retrospective review was conducted analyzing the radiographic and clinical outcome of patients treated for a radiocarpal dislocation from 1979 to 2010. Outcome assessments included wrist range of motion, grip strength, Mayo wrist score, patient-rated wrist evaluation (PRWE), and disabilities of the arm, shoulder and hand (DASH) score. Statistical analysis was performed with the Student's t test. RESULTS: Twenty-six patients (26 wrists) were treated for a radiocarpal dislocation during the study period; 23 wrists were treated acutely (within 4 weeks of injury), and 3 were treated after a delayed presentation (>4 weeks). Clinical follow-up of more than 6 months was available in 17 patients. Three patients (12 %) underwent primary fusion as initial treatment (two radioscapholunate fusion; one total wrist fusion). Four wrists (24 %) failed initial treatment and were salvaged with scapholunate ligament reconstruction (one wrist) or partial wrist fusion (three wrists). Seventeen patients completed PRWE and DASH questionnaires with a mean of 14.6 years following surgery (range 2-32 years). Subjective outcomes tended to be superior in those patients treated with ligament reconstruction versus partial or complete wrist fusion; however, comparisons were not statistically significant. CONCLUSION: Radiocarpal dislocations result in significant osseous and ligamentous injury to the distal radius and carpus. Early recognition and treatment of radiocarpal dislocations with open reduction, internal fixation, and repair of ligaments may result in improved long-term functional outcomes when compared to acute partial or complete wrist arthrodesis.

Ligamentous radiocarpal fracture-dislocation treated with wrist-spanning plate and volar ligament repair.

Background Radiocarpal fracture-dislocations are challenging injuries that are often associated with postoperative pain, stiffness, instability, or early arthrosis. Case Description We report a 1-year follow-up of a ligamentous radiocarpal dislocation (Dumontier group I) treated with a dorsal wrist-spanning plate and volar capsular repair with good results. Literature Review Historically, Dumontier group I injuries treated with a variety of techniques (closed reduction and casting, percutaneous pinning, and open fixation) have been associated with stiffness and loss of reduction. Clinical Relevance Distraction plating is a safe and effective technique for treating select distal radius fractures, and we suggest it has the potential to produce good outcomes when used to treat radiocarpal fracture-dislocations.