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Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2024, vol. 30, issue4
Subject Area: Medicine
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DOI: 10.5272/jimab.2024304.5811
Published online: 11 October 2024
Case report
J of IMAB. 2024 Oct-Dec;30(4):5811-5818
NEGLECTED BOTH-BONE FOREARM FRACTURE WITH DISTAL RADIOULNAR JOINT DISLOCATION: A CASE REPORT AND BRIEF LITERATURE REVIEW
Emil Simeonov
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Department of Orthopaedics and Traumatology, Faculty of Medicine, Medical University – Pleven, Bulgaria.
ABSTRACT:
Introduction: In this case, we discuss a patient with a neglected and malunited both-bone forearm fracture with distal radioulnar joint dislocation. This pattern of fracture by itself is uncommon, but the initial negligence of this trauma makes it even more rare and challenging for surgical treatment.
Case report: The main aim of the surgery was to restore the forearm's function and anatomy. After thorough preoperative preparation, including planning the level of resections, the patient was treated with open reduction and internal fixation with a limited contact dynamic compression plate. The distal radio-ulnar joint was fixed with 2 K-wires. On control follow-up six months later, the resection sites were fully consolidated, with no visible deformation of the forearm. Pronosupination was restored up to 60% of normal functional arc.
Conclusion: This case has shown that even with careful restoration of forearm anatomy, results of the surgical treatment in neglected and malunited both-bone forearm fracture with distal radioulnar dislocation will not be a priori good or excellent. Surgeons need to remind the patients that the return of the function of the upper limb to the degree before the trauma cannot be guaranteed.
Keywords: Forearm, Galeazzi, Reconstruction, Deformity, Malunion,
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Please cite this article as: Simeonov E. Neglected both-bone forearm fracture with distal radioulnar joint dislocation: a case report and brief literature review. J of IMAB. 2024 Oct-Dec;30(4):5811-5818. [Crossref - 10.5272/jimab.2024304.5811]
Correspondence to: Dr Emil Simeonov, MD, PhD, Clinic of Orthopaedics & Traumatology, UMBAL "Dr. Georgi Stranski"- Pleven; 89, Ruse Blvd., Pleven 5803, Bulgaria; E-mail: emil.simeonov.pl@gmail.com
REFERENCES:
1. Sebastin SJ, Chung KC. A Historical Report on Riccardo Galeazzi and the Management of Galeazzi Fractures. J Hand Surg Am. 2010 Nov;35(11):1870-7. [PubMed]
2. Panagopoulos A, Solou K, Tatani I, Kouzelis A, Kokkalis Z. A Case of Bilateral Galeazzi Fracture-Dislocations. Cureus. 2021 Aug 27;13(8):e17491. [PubMed]
3. Mikić ZD. Galeazzi fracture-dislocations. J Bone Joint Surg Am. 1975 Dec;57(8):1071-80. [PubMed]
4. Jain SK, Kohli GBS Diaphyseal Fracture of both Bone Forearm with Distal Radio-Ulnar Joint Dislocation- An Unusual Entity. J Clin Exp Orthop. 2018; 4(1):53. [Crossref]
5. Dabas V, Bhatia N, Agrawal G. Both Bone Forearm Fracture with Complex DRUJ Dislocation: What Are the Odds? J Wrist Surg. 2021 Dec 13;12(1):81-85. [PubMed]
6. Knight RA, Purvis GD. Fractures of both bones of the forearm in adults. J Bone Joint Surg Am. 1949 Oct;31A(4):755-64. [PubMed]
7. Ryan MK, MacKay BJ, Tejwani NC. Both-bone forearm fracture with distal radioulnar joint dislocation. Am J Orthop (Belle Mead NJ). 2013 May;42(5):E30-2. [PubMed]
8. Albert SM, Wohl MA, Rechtman AM. Treatment of the disrupted radio-ulnar joint. J Bone Joint Surg Am. 1963 Oct;45(7):1373-1381 [PubMed]
9. Vesely DG. The distal radio-ulnar joint. Clin Orthop Relat Res. 1967 Mar-Apr;51:75-91. [PubMed]
10. Bruckner JD, Lichtman DM, Alexander AH. Complex dislocations of the distal radioulnar joint. Recognition and management. Clin Orthop Relat Res. 1992 Feb;(275):90-103. [PubMed]
11. Budgen A, Lim P, Templeton P, Irwin LR. Irreducible Galeazzi injury. Arch Orthop Trauma Surg. 1998;118(3):176-8. [PubMed]
12. Jenkins NH, Mintowt-Czyz WJ, Fairclough JA. Irreducible dislocation of the distal radioulnar joint. Injury. 1987 Jan;18(1):40-3. [PubMed]
13. Vaishya R, Shrestha SK, Vaish A. A Galeazzi-variant type fracture-dislocation in adults. Chin J Traumatol. 2013; 16(6):344-63. [PubMed]
14. Nagy L, Jankauskas L, Dumont CE. Correction of forearm malunion guided by the preoperative complaint. Clin Orthop Relat Res. 2008 Jun;466(6):1419-28. [PubMed]
15. Jayakumar P, Jupiter JB. Reconstruction of malunited diaphyseal fractures of the forearm. Hand (N Y). 2014 Sep;9(3):265-73. [PubMed]
16. Dimartino S, Pavone V, Carnazza M, Cuffaro ER, Sergi F, Testa G. Forearm Fracture Nonunion with and without Bone Loss: An Overview of Adult and Child Populations. J Clin Med. 2022 Jul 15;11(14):4106. [PubMed]
17. Gummesson C, Atroshi I, Ekdahl C. The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgery. BMC Musculoskelet Disord. 2003 Jun 16;4:11. [PubMed]
18. Dumontier C, Soubeyrand M. The Forearm Joint. In: Bentley, G. (eds) European Surgical Orthopaedics and Traumatology. Springer, Berlin, Heidelberg. 2014, pp.1509-1524. [Crossref]
19. Soubeyrand M, Wassermann V, Hirsch C, Oberlin C, Gagey O, Dumontier C. The middle radioulnar joint and triarticular forearm complex. J Hand Surg Eur Vol. 2011 Jul;36(6):447-54. [PubMed]
20. Artiaco S, Fusini F, Sard A, Dutto E, Massè A, Battiston B. Fracture-dislocations of the forearm joint: a systematic review of the literature and a comprehensive locker-based classification system. J Orthop Traumatol. 2020 Dec 2;21(1):21. [PubMed]
21. LaStayo PC, Lee MJ. The forearm complex: anatomy, biomechanics and clinical considerations. J Hand Ther. 2006 Apr-Jun;19(2):137-44. [PubMed]
22. Somford MP, Nieuwe Weme RA, van Dijk CN, IJpma FF, Eygendaal D. Are eponyms used correctly or not? A literature review with a focus on shoulder and elbow surgery. Evid Based Med. 2016 Oct;21(5):163-71. [PubMed]
23. Viveen J, Somford MP, Koenraadt KLM, van den Bekerom MPJ, Eygendaal D, Schipper IB, et al. The Use of Eponyms for Surgical Approaches and Fractures in Elbow Surgery: Accuracy and Reliability Pre- and Post-Training. Arch Bone Jt Surg. 2019 Mar;7(2):191-198. [PubMed]
24. Murphy F., Gunn H. Eponyms in imaging of the upper limb: A historical review. Radiography. 2012 May;18(2):123-131. [Crossref]
25. Schulte LM, Meals CG, Neviaser RJ. Management of adult diaphyseal both-bone forearm fractures. J Am Acad Orthop Surg. 2014 Jul;22(7):437-46. [PubMed]
26. Graham TJ, Fischer TJ, Hotchkiss RN, Kleinman WB. Disorders of the forearm axis. Hand Clin. 1998 May;14(2):305-16. [PubMed]
27. Roth K, van Es E, Kraan G, Eygendaal D, Colaris J, Stockmans F. Accuracy of 3D Corrective Osteotomy for Pediatric Malunited Both-Bone Forearm Fractures. Children (Basel). 2022 Dec 23;10(1):21. [PubMed]
28. Abe S, Murase T, Oka K, Shigi A, Tanaka H, Yoshikawa H. In Vivo Three-Dimensional Analysis of Malunited Forearm Diaphyseal Fractures with Forearm Rotational Restriction. J Bone Joint Surg Am. 2018 Sep 5;100(17):e113. [PubMed]
29. Tarr RR, Garfinkel AI, Sarmiento A. The effects of angular and rotational deformities of both bones of the forearm. An in vitro study. J Bone Joint Surg Am. 1984 Jan;66(1):65-70. [PubMed]
30. Miyake J, Oka K, Kataoka T, Moritomo H, Sugamoto K, Murase T. 3-Dimensional deformity analysis of malunited forearm diaphyseal fractures. J Hand Surg Am. 2013 Jul;38(7):1356-65. [PubMed]
31. Dumont CE, Thalmann R, Macy JC. The effect of rotational malunion of the radius and the ulna on supination and pronation. J Bone Joint Surg Br. 2002 Sep;84(7):1070-4. [PubMed]
32. Schemitsch EH, Richards RR. The effect of malunion on functional outcome after plate fixation of fractures of both bones of the forearm in adults. J Bone Joint Surg Am. 1992 Aug;74(7):1068-78. [PubMed]
33. Lee SK, Kim YH, Kim SM, Choy WS. A comparative study of three different surgical methods for both-forearm-bone fractures in adults. Acta Orthop Belg. 2019 Sep;85(3):305-316. [PubMed]
34. Xiao AX, Graf AR, Dawes A, Daley C, Wagner ER, Gottschalk MB. Management of Acute Distal Radioulnar Joint Instability Following a Distal Radius Fracture: A Systematic Review and Meta-Analysis. J Hand Surg Glob Online. 2021 Mar 31;3(3):133-138. [ PubMed ]
35. Mader K, Koolen M, Flipsen M, van der Zwan A, Pennig D, Ham J. Complex forearm deformities: operative strategy in posttraumatic pathology. Obere Extrem. 2015;10(4):229-239. [PubMed]
36. Chia DS, Lim YJ, Chew WY. Corrective osteotomy in forearm fracture malunion improves functional outcome in adults. J Hand Surg Eur Vol. 2011 Feb;36(2):102-6. [PubMed]
37. Barinaga G, Rodriguez-Feo C, Rasmussen E, Telfer S, Iannuzzi N. The Effect of Forearm Shortening on Forearm Range of Motion. J Hand Surg Am. 2022 Jan;47(1):87.e1-87.e7. [PubMed]
38. Alemayehu DG, Zhang Z, Tahir E, Gateau D, Zhang DF, Ma X. Preoperative Planning Using 3D Printing Technology in Orthopedic Surgery. Biomed Res Int. 2021 Oct 12;2021:7940242. [PubMed]
39. Xiong L, Li X, Li H, Chen Z, Xiao T. The efficacy of 3D printing-assisted surgery for traumatic fracture: a meta-analysis. Postgrad Med J. 2019 Aug;95(1126):414-419. [PubMed]
40. Morgan C, Khatri C, Hanna SA, Ashrafian H, Sarraf KM. Use of three-dimensional printing in preoperative planning in orthopaedic trauma surgery: A systematic review and meta-analysis. World J Orthop. 2020 Jan 18;11(1):57-67. [PubMed]
41. Meyer-Szary J, Luis MS, Mikulski S, Patel A, Schulz F, Tretiakow D, et al. The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical Professionals-Cross-Sectional Multispecialty Review. Int J Environ Res Public Health. 2022 Mar 11;19(6):3331. [PubMed]
Received: 15 April 2024
Published online: 11 October 2024