Background/Objectives: Acute isolated distal radioulnar joint (DRUJ) dislocations are rare and often misdiagnosed during initial evaluation due to subtle clinical presentation, low index of suspicion, and imaging barriers. Prompt diagnosis and treatment are critical to avoid chronic instability, limited wrist mobility, and osteoarthritis. This systematic review evaluates the functional outcomes of conservative and surgical treatment protocols for acute isolated DRUJ dislocations. Methods: A systematic search of PubMed, Scopus, and Mendeley databases (2000–2024) was conducted following PRISMA guidelines. Inclusion criteria involved adult patients with isolated DRUJ dislocations diagnosed and managed within one week of injury. Studies reporting on underage patients, associated fractures, delayed management, and open injuries were excluded. Data on demographics, injury mechanism, diagnostic methods, treatment protocols, and functional outcomes were extracted and analyzed. Results: In total, 22 cases across 20 studies were included. The majority (90.9%) were males, with a mean age of 37.9 years (range: 20–70 years). Falls and sports injuries were the major causes, with volar dislocations predominating (18/22). The misdiagnosis rate was equal to 18%. Most cases were treated conservatively with closed reduction and immobilization for an average of 4.9 weeks. Operative treatment was performed in 6 cases, mainly following failed closed reductions. Functional outcomes were generally favorable, although the same parameters were not consistently studied in all patients. Overall, 82% (14 of 17 patients) achieved a full range of motion; 88% (14 of 16 patients) reported no pain, and all assessed cases had stable DRUJs at follow-up. Conclusions: This review highlights the rarity and diagnostic challenges of this injury. The functional outcomes of both conservative and operative treatment are generally satisfactory. Conservative treatment should be the first-line approach, with surgery reserved for irreducible or unstable cases. Future research using standardized outcome measures is needed to provide guidance for clinicians.

Introduction: Distal radius fracture (DRF) is the most common fall‐related fracture, with an incidence of up to 18% of the elderly population who are being examined in the emergency department. Conservative treatment in the geriatric population is the treatment of choice, and traditionally the wrist after reduction is placed in volar flexion and ulnar deviation position (Cotton position). The aim of this study is to compare two‐cast position (Cotton and Functional position) for conservative treatment of geriatric DRFs, according to functional outcomes at twelve months. Patients and Methods: This randomized prospective study compared and evaluated the functional outcomes and cost of physiotherapy in the geriatric population with DRFs. Regarding functional outcomes, these were measured using the QuickDASH Score, Patient‐Reported Wrist Evaluation, pain (VAS score), and health‐related quality of life measurement (15D), while for the cost of physical therapy, the number of sessions performed by patients in both groups was measured. Results: Ninety‐three patients (75 female and 18 men) with an average age 79.2 ± 6 (range 67–90 years) with a DRF were included in the study. Among these patients, 9 underwent surgical intervention due to loss of reduction and were consequently excluded from our study. The study ultimately encompassed a total of 84 patients. The mean age for Group A was 79 ± 2 years, and for Group B, it was 79 ± 1 years ( p = 0.61). The mean follow up for all patients was 1 year. Functional cast‐position group (Group B) showed better results in terms of functional recovery: PRWE (Mdiff = 1.52, 95% CI [−7.77, 3.81]), QuickDASH Score (Mdiff = 8.00, 95% CI [2.27, 13.72]), and posttraumatic pain (Mdiff = 1.27, 95% CI [0.86, 1.69]). Cost of physiotherapy ( z = 128, p < 0.001) and HRQol‐15(Mdiff = 1.81, 95% CI [1.02, 2.60]) was statistically significantly greater in the Cotton position group versus Functional position group. Conclusion: Our results indicate that functional cast‐position produces better functional outcomes with a lower rate of complication than volar‐flexion and ulnar‐deviation cast (VFUDC) position. Despite the fact that the VFUDC group underwent a greater number of physical therapies, they presented less good functional results. In conclusion we recommend the use of functional cast in elderly low energy DRFs.

Background and Clinical Significance: Talar body fractures are very rare injuries, and their occurrence alongside ipsilateral fractures is even more uncommon. We present a case of a 40-year-old male who sustained a talar body fracture combined with an ipsilateral bimalleolar fracture after falling from a height, a combination previously described in only two cases. Case Presentation: Open reduction and internal fixation (ORIF) were performed using dual approaches for both the talus and malleolar fractures. Postoperatively, the rehabilitation protocol included a non-weight-bearing short leg cast, followed by partial weight-bearing with a controlled ankle movement (CAM) boot. At one-year follow-up, the patient achieved an American Orthopedic Foot and Ankle Society (AOFAS) score of 90 and reported minimal pain. Radiographs demonstrated minimal osteoarthritic changes and no signs of osteonecrosis. Nevertheless, early signs of osteonecrosis (ARCO grade I) were detected on MRI 15 months postoperatively. Conclusions: This case highlights the rarity of such injuries, outlines our institution’s treatment approach, and emphasizes the importance of long-term follow-up to monitor for complications such as post-traumatic arthritis and osteonecrosis.