Johnathan A Bernard1, Andres O'Daly1, Dawn M Laporte2. 1. Division of Hand and Upper Extremity Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287 USA. 2. Division of Hand and Upper Extremity Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD 21287 USA ; c/o Elaine P. Henze, BJ, ELS, Medical Editor and Director, Editorial Services, Department of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., #A665, Baltimore, MD 21224-2780 USA.
Abstract
BACKGROUND: Fracture-dislocations of the carpus are rare, generally occurring after high-energy trauma. Goldenhar syndrome is among a group of genetic abnormalities associated with radial limb defects. We present a case of a dorsal radiocarpal dislocation in a patient with Goldenhar syndrome after a low-energy fall. To our knowledge, there has been no previous report of radiocarpal dislocation in the setting of Goldenhar syndrome. METHODS: This patient with Goldenhar syndrome had a dorsal radiocarpal dislocation in the setting of an absent scaphoid and dysplastic distal radius. A computed tomography scan, recognized as a useful modality to evaluate the wrist and scaphoid, was used to rule out any other osseous trauma or avulsion fractures. RESULTS: Closed reduction and 6 weeks of immobilization resulted in a successful treatment. CONCLUSIONS: The incidence of radiocarpal dislocations in patients with Goldenhar syndrome and the appropriate long-term treatment for patients with Goldenhar syndrome with radiocarpal dislocations require further investigation.
BACKGROUND:Fracture-dislocations of the carpus are rare, generally occurring after high-energy trauma. Goldenhar syndrome is among a group of genetic abnormalities associated with radial limb defects. We present a case of a dorsal radiocarpal dislocation in a patient with Goldenhar syndrome after a low-energy fall. To our knowledge, there has been no previous report of radiocarpal dislocation in the setting of Goldenhar syndrome. METHODS: This patient with Goldenhar syndrome had a dorsal radiocarpal dislocation in the setting of an absent scaphoid and dysplastic distal radius. A computed tomography scan, recognized as a useful modality to evaluate the wrist and scaphoid, was used to rule out any other osseous trauma or avulsion fractures. RESULTS: Closed reduction and 6 weeks of immobilization resulted in a successful treatment. CONCLUSIONS: The incidence of radiocarpal dislocations in patients with Goldenhar syndrome and the appropriate long-term treatment for patients with Goldenhar syndrome with radiocarpal dislocations require further investigation.