Wrist and radius joint dislocation

　　Wrist sprain, or lifting heavy objects to cause radial deviation, extension, or rotation of the wrist joint, all of which can cause wrist and radius joint dislocation. Clinically, when the forearm pronates, the head of the ulna protrudes to the dorsal side, and it automatically reduces when supinated.

　　According to different periods, wrist and radius joint dislocation can produce different complications, as follows:

　　First, early complications

　　1. Fracture is a common complication of dislocation, often occurring near the joint or the joint itself, or in a small number of cases, in the same limb as the dislocation.

　　2. Nerve injury, although a rare complication of dislocation, can cause adverse results for the recovery and prognosis of the dislocation if it occurs.

　　3. Vascular injury is a rare complication among dislocation complications. If a large vascular injury occurs, swelling will be rapid, and the patient will quickly go into shock.

　　Second, late complications

　　1. Ischemic necrosis of bone. Due to the injury of the joint capsule, ligament, or related muscle after joint dislocation, the blood supply to the bone is affected, and over time, the bone may necrose due to insufficient blood supply.

　　2. Osteochondromatosis. Most people believe that the pathogenesis of osteochondromatosis is due to the injury of the periosteum, where the bone cells in the periosteum become free in the hematoma around the joint, and undergo ossification in the hematoma.

　　4. Habitual dislocation. After joint reduction, if the joint is used prematurely, the surrounding soft tissue or articular cartilage damage may not heal well, leading to joint instability and fascial relaxation.

　　5. Traumatic arthritis. Traumatic arthritis often occurs when the articular cartilage surface is damaged during dislocation, causing malalignment of the joint surface.

　　Distal radioulnar joint dislocation is most common with dorsal dislocation. At this time, when the forearm is pronated, the ulnar head protrudes to the dorsal side, and it automatically resets when supinated. The patient has local swelling and tenderness. Passive movement of the distal radioulnar joint can feel looser than the normal side, accompanied by pain, and sometimes there is a click.

　　The most important way to prevent distal radioulnar joint dislocation is to strengthen labor protection and prevent trauma. Before sports, sufficient warm-up exercises should be done to increase the excitability, response ability, and resistance ability of muscle tissue, gradually increase the degree of resistance, and it is helpful to reduce joint dislocation. Children should be avoided from being pulled too hard.

　　In the diagnosis of distal radioulnar joint dislocation, in addition to relying on its clinical manifestations, it is necessary to rely on chemical examination. The main inspection methods are as follows:

　　1. Physical examination

　　Wrist pain is limited to the distal radioulnar joint and the styloid process of the ulna, and increases during rotation and ulnar deviation. The elastic boss is compared with the healthy side, and it can be seen that the ulnar head is raised on the dorsal or palmar side, which can be reset when pressed and bounce back when lifted.

　　2. Auxiliary examination

　　X-ray films should be compared on both sides to facilitate observation and judgment.

　　Patients with distal radioulnar joint dislocation should enhance nutrition, eat more protein-rich foods such as fish, eggs, soy products, and appropriately increase calcium. Drink more water, eat more vegetables and fruits. In addition, patients should pay attention to avoiding spicy foods such as chili and mustard. Habits such as smoking and drinking should be quit.

　　The distal radioulnar joint palmar dislocation is more serious, with obvious limitation of wrist and forearm rotation activities, except for wrist swelling and pain, the ulnar head protrudes towards the palmar side. At this time, the ulnar head often locks in the dislocation position and needs to be复位 under anesthesia. When复位, the forearm should be in the supinated position and the ulnar head should be pushed towards the dorsal side. After复位, the short arm cast brace should be immobilized for 4-6 weeks, and the forearm should be in the pronated position.