Document Type : Case Report


Department of Orthopaedics, Government Medical College Hospital, Sector 32, Chandigarh, 160030, India


Objective: Distal radioulnar joint (DRUJ) subluxation with associated both bones forearm fracture is a rare clinical entity and is easily missed, leading to significant functional limitations.
Case Presentation: A 28-year-old male fell on the outstretched hand and suffered left side both bones forearm shaft fracture with ipsilateral DRUJ disruption. Operative intervention in the form of plating was done for both bones forearm shaft fracture and DRUJ was stabilised with one k wire and above elbow plaster splint in full supination was given for 6 weeks. At one-year follow-up, fracture was united and Disabilities of the Arm, Shoulder and Hand (DASH) score was 11.7, and he was well satisfied.
Conclusion: DRUJ disruption should be carefully evaluated in all the patients with associated shaft fractures of radius and ulna. Timely diagnosis and optimal intervention may prevent any functional limitations.


Main Subjects

1. Kim SB, Heo YM, Yi JW, Lee JB, Lim BG. Shaft fractures of both forearm bones: the outcomes of surgical treatment
with plating only and combined plating and intramedullary nailing. Clin Orthop Surg 2015; 7(3): 282-90. doi: 10.4055/
2. 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; 84(7): 1070-4. doi: 10.1302/0301-620x.84b7.12593.
3. Matthews LS, Kaufer H, Garver DF, Sonstegard DA. The effect on supination-pronation of angular malalignment of
fractures of both bones of the forearm. J Bone Joint Surg Am 1982; 64(1): 14-7.
4. Mirghasemi AR, Lee DJ, Rahimi N, Rashidinia S, Elfar JC. Distal radioulnar joint instability. Geriatr Orthop Surg
Rehabil 2015; 6(3): 225-9. doi: 10.1177/2151458515584050.
5. Streubel PN, Pesántez RF. Diaphyseal fractures of the radius and ulna. In: Rockwood, Green, and Wilkins Fractures in
Adults and Children. 8th ed. Wolters Kluwer Health Adis (ESP); 2014.
6. Rodriguez-Martin J, Pretell-Mazzini J. The role of ultrasound and magnetic resonance imaging in the
evaluation of the forearm interosseous membrane. A review. Skeletal Radiol 2011; 40(12): 1515-22. doi: 10.1007/
7. Henry AK. Complete Exposure of the Radius. Bristol, England: John Wright & Sons Ltd; 1927.
8. Catalano LW 3rd, Zlotolow DA, Hitchcock PB, Shah SN, Barron OA. Surgical exposures of the radius and
ulna. J Am Acad Orthop Surg 2011; 19(7): 430-8. doi:10.5435/00124635-201107000-00006.
9. 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; 4: 11. doi: 10.1186/1471-2474-4-11.
10. Kose O, Durakbasa MO, Islam NC. Posterolateral elbow dislocation with ipsilateral radial and ulnar diaphyseal
fractures: a case report. J Orthop Surg (Hong Kong) 2008; 16(1): 122-3. doi: 10.1177/230949900801600129.
11. Fleming FJ, Flavin R, Poynton AR, Glynn T. Elbow dislocation with ipsilateral open radial and ulnar diaphyseal
fractures--a rare combination. Injury 2004; 35(1): 90-2. doi: 10.1016/s0020-1383(02)00143-2.
12. Wijffels M, Brink P, Schipper I. Clinical and non-clinical aspects of distal radioulnar joint instability. Open Orthop J
2012; 6: 204-10. doi: 10.2174/1874325001206010204.
13. Dukan R, Kassab Hassan S, Delvaque JG, Khaled I, Nizard R. Isolated volar dislocation of the distal radioulnar joint:
a case report. J Orthop Case Rep 2020; 10(2): 97-100. doi:10.13107/jocr.2020.v10.i02.1716