Wrist Dislocation: Treatment Options and Risks - Orthopedics

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Wrist dislocation, particularly involving the distal radioulnar joint (DRUJ), can be a complex injury that requires careful evaluation and management. The fact that your dislocation was delayed in treatment for 70 days raises some concerns about potential complications and the need for surgical intervention.


Understanding Wrist Dislocation
A wrist dislocation occurs when the bones in the wrist are forced out of their normal positions. This can happen due to trauma, such as a fall or a sports injury. The distal radioulnar joint is where the radius and ulna bones meet near the wrist, and dislocation here can lead to significant functional impairment if not treated properly.


Treatment Options
1. Conservative Management: In some cases, if the dislocation is not severe and there is no significant damage to the surrounding ligaments or cartilage, conservative treatment may be considered. This typically involves immobilization with a splint or cast, followed by physical therapy to regain strength and range of motion. However, given that 70 days have passed since the injury, this option may not be viable.

2. Surgical Intervention: If the dislocation has not been reduced (realigned) and there are signs of instability, pain, or loss of function, surgery may be necessary. Surgical options can include:
- Open Reduction and Internal Fixation (ORIF): This procedure involves surgically repositioning the bones and securing them with hardware (plates, screws) to ensure proper alignment during healing.

- Arthroscopy: In some cases, minimally invasive techniques can be used to address soft tissue injuries or to assist in the reduction of the dislocation.


Risks of Delayed Treatment
Delaying treatment for a wrist dislocation can lead to several complications, including:
- Chronic Pain: Persistent pain may develop if the joint is not properly aligned.

- Loss of Range of Motion: Scar tissue can form, leading to stiffness and reduced mobility.

- Arthritis: Long-term misalignment can lead to degenerative changes in the joint, resulting in arthritis.

- Nerve or Vascular Injury: Prolonged dislocation can potentially damage nearby nerves or blood vessels, leading to further complications.


Potential Outcomes Without Surgery
If you choose not to undergo surgery, the potential outcomes can vary widely:
- Persistent Symptoms: You may continue to experience pain, swelling, and limited mobility.

- Functional Impairment: Daily activities that require wrist movement may become challenging, impacting your quality of life.

- Risk of Permanent Damage: In some cases, untreated dislocations can lead to permanent joint instability or deformity, which could be considered a form of disability.


Conclusion
Given the complexity of wrist dislocations and the potential for long-term complications, it is crucial to have a thorough discussion with your orthopedic surgeon about the best course of action. They can provide a detailed assessment of your specific situation, including the condition of the joint, surrounding structures, and your overall health. If surgery is recommended, it is often to prevent further complications and to restore function to the wrist. If you have concerns about surgery, discussing these with your doctor can help you make an informed decision that aligns with your health goals.