Management of acute distal radioulnar dislocations associated with radial shaft substance loss.

In patients with distal radioulnar dislocations that are associated with a loss of radial shaft substance, the use of an external distractor that is applied to the distal radial fragment and the proximal ulnar shaft allows proper reduction of distal radioulnar articulation. The pins should be placed close to a joint so that the holes left after the pins are removed do not act as diaphyseal stress risers. The position is maintained by appropriate internal fixation and bone grafting of the radius. In cases where the bone is severely crushed and internal fixation cannot be applied, the external distractor may be converted to an external fixator.