MANAGEMENT OF COMPLEX DISLOCATIONS OF THE DISTAL RADIOULNAR JOINT

The authors reviewed their experience in the treatment of complex disl ocations of the distal radioulnar joint. Six cases of complex dislocat ions were treated between 1990 and 1993. An algorithm for the treatmen t of these injuries has been developed. In most cases, complex disloca tions are associated with an avulsion fracture of the ulnar styloid. T he authors prefer to treat these by fixation of the ulnar styloid usin g a tension band wiring technique. Cases in which the ulnar styloid fr agment is small, or in which there is no styloid fracture, are treated with open reduction and repair of the triangular fibrocartilage compl ex if the distal radioulnar joint is irreducible, or by ulnoradial tra nsfixion pinning if the distal radioulnar joint is reducible but unsta ble. Good results were obtained in five of six cases using this algori thm.