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

ABSTRACT

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.