The Journal of Bone and Joint Surgery, Vol 74, Issue 10 1486-1497, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc
Radio-ulnar dissociation. A review of twenty cases
RT Trousdale, PC Amadio, WP Cooney and BF Morrey
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905.
The results of treatment were reviewed for twenty patients who had
sustained concomitant injuries of the lateral compartment of the
radiohumeral joint and the ipsilateral distal radio-ulnar joint. The ages
of the patients ranged from eight to seventy-four years (average,
thirty-five years) and the duration of follow-up ranged from four months to
twenty-seven years (average, 113 months). In fifteen patients, the injury
of the wrist was diagnosed after a mean delay of seven years and eleven
months (range, one month to twenty-six years). In all fifteen, the radial
head injury was treated by excision, either initially or after some delay.
After excision of the radial head, all fifteen patients complained of
severe pain at the distal radio-ulnar joint. The results, on the basis of
elbow and wrist scores of fair or better without complications, were
satisfactory in only three patients. In the remaining five patients, in
whom the injuries of both the elbow and the wrist had been identified at
the initial evaluation, the radial head was either preserved or replaced.
The results, on the basis of elbow and wrist scores of fair or better, were
graded as satisfactory in four of these patients. Our data show that any
injury to the lateral side of the elbow should prompt a careful evaluation
of the ipsilateral distal radio-ulnar joint for associated instability.
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