CASE REPORT SURGERY DEPARTMENT

Disruptio at Distal Radioulnar Joint

EMERGENCY ROOM
BAHTERAMAS GENERAL HOSPITAL
KENDARI
 IDENTITY

Name : Mrs. HM
Age : 42 years old
Sex : Female
Address : Morini Village
Occupation : Housewife
Admission : March 26th 2019
Doctor in charge : dr. Mario Polo Wijaya, M.Kes , Sp.OT
 Anamnesis (06.35)
Chief complain : Pain at the right wrist
History Taking
Suffered since ± 5 months ago before admission to the hospital. The
pain was radiated to upper arm. Pain was intermittent, increased by
supine or pronate forearm, decreased by rest.
Mechanism of trauma : : Patient was at the airport lifting up her luggage
with right hand but suddenly there was another people beside her also lifted
luggage and hit her right wrist.
History of Trauma
 There was a dominant right hand

 There was history of previous treatment: analgesic

 PHYSICAL EXAMINATION(06.40)

General Condition : Moderate illness

Composmentis (GCS 15 E4V5M6),
Good Nourish

Vital Sign
BP : 110/80 mmHg
HR : 84x/minutes, regular, strong
RR : 22x/minutes regular, spontaneous, symetris
T : 36.5 ◦C / axillar
VAS : 5/10
 PRESENT STATE

Head : Within Normal Limit

Ears : Within Normal Limit
Face : Within Normal Limit
Neck : Within Normal Limit
Eyes : Within Normal Limit
Chest : Within Normal Limit
Nose : Within Normal Limit
Upper Limb : Localized State
Mouth : Within Normal Limit
Lower Limb : Within Normal Limit
Localized state (Right wrist)

Right Wrist
 Inspection: Deformity (-), swelling (+), hematoma (-),
wound (-)
 Palpation : tenderness (+), crepitation (-)
 ROM : active and passive movement of wrist
joint and elbow joint limited due to pain
 NVD : good sensibility, radial artery pulsation
(+), CRT < 2 second.
CLINICAL FINDING
 PLANNING

Routine blood test (HB, WBC, PLT)

Plain photo Wrist Joint AP/Oblique
 DIAGNOSIS

Disruptio Distal Radioulnar Joint

Differential Diagnosis :
- Fracture at Distal Radius
- Dislocation at Distal Radioulnar joint
 MANAGEMENT
Pharmacological Non-Pharmacological
• IVFD
 Rest
• Analgesic injection
• H2R antagonist injection  Immobilization

 Education

Consult to orthopaedic surgeon

Thank You