Journal of Musculoskeletal Trauma

Radiocarpal subluxation after volar plating due to an insufficiently supported dorsal key fragment: a case report: Yeongyoon Koh, Kanghun Yu, Jong Woong Park, In Cheul Choi; Received April 28, 2026 Accepted May 13, 2026 Published online July 3, 2026; DOI: https://doi.org/10.12671/jmt.2026.00185 [Epub ahead of print]

Abstract PDF: Distal radius fractures are commonly managed using volar locking plate fixation, which provides stable fixation in most cases. However, certain fracture patterns involving dorsal key fragments may not be adequately stabilized with a volar approach alone, even when intraoperative reduction appears satisfactory. We report the case of a 58-year-old male patient with a complex intra-articular distal radius fracture involving a dorsoulnar corner (DUC) fragment. Preoperative computed tomography revealed a dorsal fragment associated with subtle dorsal radiocarpal subluxation. Despite this finding, the fragment was considered amenable to fixation through a volar approach because it was relatively large. Although satisfactory reduction was achieved intraoperatively, early postoperative imaging demonstrated progressive dorsal radiocarpal subluxation due to displacement of the DUC fragment, while overall alignment parameters remained preserved. Revision surgery with additional dorsal buttress fixation successfully restored stability. This case highlights the critical importance of recognizing dorsal key fragments and achieving adequate dorsal support during fixation, as failure to provide sufficient support may result in delayed instability despite acceptable initial reduction.

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Diagnosis and Management of Ligament Injuries of the Wrist: Ki Tae Na, Joo Yup Lee; J Korean Fract Soc 2016;29(2):160-170. Published online April 30, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.2.160

Abstract PDF: The wrist joint is formed by the distal end of the radius and ulna proximally, and eight carpal bones distally. It has many ligaments to maintain stability of the complex bony structures. The incidence of ligament injuries of the wrist has increased due to sports activities. However, diagnosis and management of these injuries are sometimes difficult because of the anatomic complexity and variable injury patterns. Among them, scapholunate ligament injury and triangular fibrocartilage tears are the two most common injuries resulting in chronic disabling wrist pain. Thorough understanding of the wrist anatomy and physical and radiologic examination is mandatory for proper diagnosis and management of these conditions. This article will briefly discuss the wrist joint anatomy and biomechanics, and review the diagnosis and management of the scapholunate ligament injury and triangular fibrocartilage injury.

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Biomechanics of the Wrist: Young Ho Shin, Young Ho Lee; J Korean Fract Soc 2016;29(1):93-100. Published online January 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.1.93

The wrist joint is a complicated structure composed of many bones and ligaments. Therefore, understanding the anatomy and the biomechanics of the wrist is important in order to administer proper treatment for patients. To easily understand the complicated structure, there were many trials to unite the complicated structure with a simple group such as the carpal row concept and the carpal column concept. Movement and load transfer along the wrist joint occurs with balanced action between carpal bones. To evaluate this static equilibrium, measuring tools such as carpal height ratio are used. When wrist flexion/extension occurs, each carpal row moves synchronously with action of the scaphoid. In contrast with flexion/extension, when wrist radial deviation/ulnar deviation occurs, the proximal carpal row moves in the sagittal plane, instead of the coronal plane. Recently, the dart throwing motion which occurred from the position of dorsiflexion with radial deviation to volar flexion with ulnar deviation is considered the main movement of the wrist joint.

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