Vélez-de Lachica JC, Brambila-Botello CA, Valdez-Jiménez LA

Language: Spanish
References: 8
Page: 218-222
PDF size: 272.11 Kb.

ABSTRACT

The main function of the forearm is the supination, which is achieved largely through the biomechanical characteristics and stability of the distal radio-ulnar joint. There are several surgical techniques for the treatment of distal radio-ulnar dislocations isolated or associated with a fracture. We report the case of a canine trainer who was bitten at the wrist and distal forearm that came to the emergency department in where distal ulnar dislocation with muscle tendon exposure was diagnosed. Due to the offending agent and multiple soft tissue injuries the treatment with standard techniques was impossible. We describe the technique of treatment of this patient by placing autologous gracilis tendon graft, platelet rich plasma and two anchoring systems for ankle syndesmosis. Immobilization was maintained for six weeks with a subsequent rehabilitation and posterior valuation at 12, 18 and 28 weeks by the scale of MAYO, PRWE and DASH and finding a good result which implies the return to work and daily activities of the patient with minimal pain and limitation.

REFERENCES

1. Dameron TB Jr: Traumatic dislocation of the distal radio-ulnar joint. Clin Orthop Relat Res. 1972; 83: 55-63.

2. Seo KN, Park MJ, Kang HJ: Anatomic reconstruction of the distal radioulnar ligament for posttraumatic distal radioulnar joint instability. Clin Orthop Surg. 2009; 1(3): 138-45.

3. Green D, Hotchkiss R, Pederson W: Cirugía de la mano. 4.a ed. Madrid: Editorial Médica Panamericana; 2007.

4. Palmer AK: Triangular fibrocartilage complex lesions: a classification. J Hand Surg Am. 1989; 14(4): 594-606.

5. Garrigues GE, Aldridge JM 3rd: Acute irreducible distal radioulnar joint dislocation. A case report. J Bone Joint Surg Am. 2007; 89(7): 1594-7.

6. Kataoka T, Moritomo H, Omokawa S, Iida A, Wada T, Aoki M: Palmar reconstruction of the triangular fibrocartilage complex for instability of the distal radioulnar joint: a biomechanical study. The journal of hand surgery. J Hand Surg Eur Vol. 2013; 38(5): 515-22.

7. Anderson ML, Larson AN, Moran SL, Cooney WP, Amrami KK, Berger RA: Clinical comparison of arthroscopic versus open repair of triangular fibrocartilage complex tears. J Hand Surg Am. 2008; 33(5): 675-82.

8. Muller M, Allgower M, Schneider R, Willenegger H: Manual de osteosíntesis. Técnicas recomendadas por el grupo AO. 3.a ed. Barcelona: Springer-Verlag Ibérica; 1993: 751.