Comprehensive review of radiocarpal fracture-dislocations — a rare, high-energy wrist injury accounting for ~0.2% of wrist injuries. Covers anatomy, injury mechanism, two classification systems (Moneim and Dumontier), radiographic evaluation, surgical treatment principles using a columnar approach, and outcomes from the largest available case series.
When you see high-energy wrist trauma with styloid fractures, immediately assess the lunate position on PA view (ulnar translocation = complete ligamentous disruption) and scrutinize for a radial styloid fracture exiting at the scapholunate interval — that pattern predicts concurrent SL ligament rupture that will drive late instability if missed.
Don't conflate this with a Barton fracture: in a Barton the articular fragment stays with the carpus and is large; in radiocarpal fracture-dislocation the carpus has separated from the radius entirely, with only small styloid or rim avulsions, and closed reduction alone is insufficient.
Comprehensive review of radiocarpal fracture-dislocations — a rare, high-energy wrist injury accounting for ~0.2% of wrist injuries. Covers anatomy, injury mechanism, two classification systems (Moneim and Dumontier), radiographic evaluation, surgical treatment principles using a columnar approach, and outcomes from the largest available case series.
When you see high-energy wrist trauma with styloid fractures, immediately assess the lunate position on PA view (ulnar translocation = complete ligamentous disruption) and scrutinize for a radial styloid fracture exiting at the scapholunate interval — that pattern predicts concurrent SL ligament rupture that will drive late instability if missed.
Don't conflate this with a Barton fracture: in a Barton the articular fragment stays with the carpus and is large; in radiocarpal fracture-dislocation the carpus has separated from the radius entirely, with only small styloid or rim avulsions, and closed reduction alone is insufficient.