Closed Reduction and Ayurvedic Conservative Management of an Isolated Dorsal Dislocation of the Distal Ulna: A Case Report

Abstract

Distal radioulnar joint (DRUJ) injuries are frequently seen in association with distal radius fractures; isolated dorsal dislocation of the distal ulna is uncommon and often difficult to diagnose, necessitating careful clinical evaluation and appropriate imaging. This should be considered in patients presenting with ulnar-sided wrist pain after trauma. Early diagnosis and appropriate management are key to prevent long-term morbidity and achieving optimal functional results. A 52-year-old male patient presented with pain, deformity and restricted movements of the left wrist joint following trauma to the left wrist. Radiographic evaluation revealed Dorsal dislocation of the distal ulna. He was treated with a closed manipulative reduction technique followed by a splint bandage with Murivenna over the left wrist joint and forearm, and was administered internal medications, which included Punarnavadi Kashayam 90ml twice daily before food, along with T. Chandraprabha 2 BD, T. Laksha guggulu 2 BD after food, and Gandha thailam 10 drops twice daily after food for 3 weeks. Re-bandaging was done every 7^th day with splints for 2 weeks and a Simple bandage without splints for the next 1 week. The patient showed a marked reduction in pain (VAS from 6 to 0), improved joint stability, and a good functional range of movement of the left wrist joint without the need for surgical intervention. The outcome of this case suggests that conservative Ayurvedic management following successful reduction is effective in the management of DRUJ instability.