Volar dislocation of the distal ulna in supination caused by apex volar malunion of the radial shaft:  a report of 2 cases.
BACKGROUND
Fractures of the distal third of the radius in children are common and most heal without incident. However, distal radial shaft malunion with apex volar angulation may lead to volar dislocation of the distal ulna with forearm supination, although it has been rarely reported. The aim of this study was to document 2 such cases and to make recommendations regarding the management of these patients.


METHODS
We report the cases of 2 boys, ages 6 and 8 years, who sustained radial shaft fractures that healed with apex volar angulation and who developed intractable volar dislocation of the distal ulna in adolescence. In both cases, corrective radial osteotomy at the site of the malunion restored full stability of the distal radial-ulnar joint without the need for soft-tissue reconstruction or ulnar styloid nonunion repair.


CONCLUSIONS
This injury pattern is rarely reported but should be considered in cases of repeated volar dislocation of the distal ulna with supination. We recommend a corrective osteotomy at the site of the malunion to restore stability to the distal radial-ulnar joint.


METHODS
IV.
Department of Hand Surgery, McGuire Veterans Hospital, Richmond, VA, USA.
William H
WH
Bowers
John W
JW
Karl
Robert J
RJ
Strauch
D000293:Adolescent; D017759:Fractures, Malunited; D006801:Humans; D004204:Joint Dislocations; D007593:Joint Instability; D008297:Male; D010027:Osteotomy / Q000379:methods*; D011885:Radius Fractures / Q000473:pathology* / Q000601:surgery; D013484:Supination; D014457:Ulna / Q000473:pathology*