Systematic review of radiocarpal dislocations: epidemiology, treatment modalities, and outcomes.

PURPOSE: Radiocarpal dislocation (RCD) is a rare but severe injury, often resulting from high-energy trauma such as motor vehicle accidents and falls. This study aims to synthesize existing case reports and series to provide insights into the epidemiology, associated injuries, and management strategies for RCD.

METHODS

A systematic search of PubMed, Scopus, and Web of Science was conducted, including English-language case reports and series up to August 5, 2023. Data extraction followed PRISMA guidelines, with bias assessment using Joanna Briggs Institute criteria. Descriptive statistics and t tests were applied to analyze demographics, treatments, and outcomes.

RESULTS

Among 343 articles, 57 met inclusion criteria, covering 303 patients. The mean age was 36.52 years, with males comprising 78.9%. Dorsal dislocations were the most common type. Fractures, particularly of the radial styloid, were present in most cases. Common soft tissue injuries included median nerve compression, TFCC/DRUJ injuries, and scapholunate ligament tears. Ligament repair, performed in 24.7% of cases, improved flexion-extension outcomes (p = 0.048) but showed no significant effects on ulnar or radial deviation. Spanning plates demonstrated acceptable outcomes in one study.

CONCLUSIONS

RCDs are complex injuries requiring comprehensive diagnostic assessment and tailored treatment strategies, particularly addressing associated fractures and soft tissue damage. While ligament repair may enhance flexion-extension, its role in overall joint stability remains uncertain. Further prospective, multicenter studies are needed to better evaluate treatment approaches, including the effectiveness of ligament repair, and to refine management protocols for improved long-term patient outcomes.