Dumontier group 2 radiocarpal fracture-dislocations: Outcomes of open or closed reduction and K-wire fixation

Radiocarpal fracture-dislocations are rare wrist injuries characterized by partial or complete loss of contact between the radial joint and the carpal bones. They are often associated with complex ligamentous injuries and comminuted distal radius fractures. Few studies have reported outcomes for this injury, and the literature consists primarily of case reports. This study aims to evaluate the functional outcomes of Kirschner wire (K-wire) fixation for managing Dumontier group 2 radiocarpal fracture-dislocations. Between 2017 and 2023, all adult patients who underwent K-wire fixation for Dumontier group 2 injuries were included in this study. Functional outcomes were evaluated based on range of motion (ROM), grip strength, and the disabilities of the arm, shoulder, and hand (QuickDASH) score. Seven patients, six males and one female, with a mean age of 27.3 years, were included. The mechanism of injury was evenly split between motor vehicle collisions and falls from height. Four patients underwent open reduction with radiocarpal pinning and/or volar capsule repair, while three underwent closed reduction with percutaneous pinning. The mean follow-up period was 7 months. Wrist flexion and extension averaged 65°, while pronation and supination measured 72°. The QuickDASH score averaged 10.1, indicating mild residual disability. Grip strength on the affected side averaged 15.1 kg. Postoperative imaging confirmed a complete radiocarpal reduction in all patients, with no evidence of residual subluxation, ulnar translation, or articular incongruity. No complications were reported. K-wire fixation is a safe method for managing Dumontier group 2 radiocarpal dislocations, providing stable reduction and favorable functional outcomes without residual subluxation or ulnar translation. These findings suggest that K-wire fixation and appropriate immobilization may be sufficient even without ligament reconstruction. Further research is needed to validate these results and assess long-term outcomes.