Distal Radius Fracture with Bone Fragment Protruded into the Radiocarpal Joint: Two Case Reports

2021 ◽  
Vol 26 (03) ◽  
pp. 460-462
Author(s):  
Kaoru Tada ◽  
Kazuo Ikeda ◽  
Hiroyuki Tsuchiya
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Case Reports ◽  
Limited Range ◽  
Radius Fracture ◽  
Bone Fragment ◽  
Dorsal Cortex ◽  
Limited Range Of Motion ◽  
Radiocarpal Joint ◽  
Bone Fragments

Distal radius fractures often involve comminuted fragments of the dorsal cortex of the radius, but bone fragments rarely protrude into the radiocarpal joint. We report two cases of distal radius fracture with bone fragment protrusion into the radiocarpal joint. To the best of our knowledge, there are no English reports of distal radius fracture with bone fragment protrusion into the radiocarpal joint. Despite the rarity of these cases, clinicians should still be mindful of such injuries and not overlook the possibility of presence of bone fragments within the joint. Missed intra-articular fragments may cause pain, limited range of motion, and subsequent osteoarthritis.

scholarly journals Volar Distal Radioulnar Joint Dislocation Associated with Acute Median Nerve Neuropathy and a Distal Radius Fracture

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Naser Alnusif ◽  
Sultan Aldebeyan ◽  
Rudolf Reindl
Keyword(s):  
Median Nerve ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Rare Case ◽  
Case Reports ◽  
Carpal Tunnel Release ◽  
Distal Radioulnar Joint ◽  
Radius Fracture ◽  
Radioulnar Joint ◽  
Median Nerve Neuropathy

Volar distal radioulnar (DRUJ) dislocations are uncommon and can easily be missed. We present a rare case of an irreducible volar DRUJ dislocation associated with a distal radius fracture and acute median nerve neuropathy at the wrist. An attempt to reduce the DRUJ dislocation in the emergency department had failed. The patient was then taken to the operating room requiring a carpal tunnel release, as well as an open reduction and internal fixation of the distal radius fracture and repair of the volar distal radioulnar ligament. We also review some of the volar DRUJ case reports in the literature.

scholarly journals Biomechanical Assessment of the Dorsal Spanning Bridge Plate in Distal Radius Fracture Fixation: Implications for Immediate Weight-Bearing

Hand ◽  
2017 ◽  
Vol 13 (3) ◽  
pp. 336-340 ◽  
Author(s):  
Jerry I. Huang ◽  
Bret Peterson ◽  
Kate Bellevue ◽  
Nicolas Lee ◽  
Sean Smith ◽  
...  
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Weight Bearing ◽  
Radius Fracture ◽  
Wedge Osteotomy ◽  
Early Weight Bearing ◽  
Axial Stability ◽  
Bridge Plate ◽  
Radiocarpal Joint ◽  
Bridge Plating

Background: The goal of this study was to compare the biomechanical stability of a 2.4-mm dorsal spanning bridge plate with a volar locking plate (VLP) in a distal radius fracture model, during simulated crutch weight-bearing. Methods: Five paired cadaveric forearms were tested. A 1-cm dorsal wedge osteotomy was created to simulate an unstable distal radius fracture with dorsal comminution. Fractures were fixed with a VLP or a dorsal bridge plate (DBP). Specimens were mounted to a crutch handle, and optical motion-tracking sensors were attached to the proximal and distal segments. Specimens were loaded in compression at 1 mm/s on a servohydraulic test frame until failure, defined as 2 mm of gap site displacement. Results: The VLP construct was significantly more stable to axial load in a crutch weight-bearing model compared with the DBP plate (VLP: 493 N vs DBP: 332 N). Stiffness was higher in the VLP constructs, but this was not statistically significant (VLP: 51.4 N/mm vs DBP: 32.4 N/mm). With the crutch weight-bearing model, DBP failed consistently with wrist flexion and plate bending, whereas VLP failed with axial compression at the fracture site and dorsal collapse. Conclusions: Dorsal spanning bridge plating is effective as an internal spanning fixator in treating highly comminuted intra-articular distal radius fracture and prevents axial collapse at the radiocarpal joint. However, bridge plating may not offer advantages in early weight-bearing or transfer in polytrauma patients, with less axial stability in our crutch weight-bearing model compared with volar plating. A stiffer 3.5-mm DBP or use of a DBP construct without the central holes may be considered for distal radius fractures if the goal is early crutch weight-bearing through the injured extremity.

Existing or Worsening Symptoms of Kienböck’s Disease after Distal Radius Fracture: Two Case Reports

2018 ◽  
Vol 23 (04) ◽  
pp. 585-588
Author(s):  
Takeshi Ogawa ◽  
Shunsuke Asakawa
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Case Reports ◽  
Combined Therapy ◽  
Compression Fracture ◽  
Radius Fracture ◽  
Lunate Bone ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Kienbock’S Disease

We report two rare cases of existing or worsening symptoms due to Kienböck’s disease after distal radius fracture (DRF). During examination, radiographs show changes in the lunate bone; there was persistent wrist pain after treatment for DRF. In each case, surgeries were performed: A combined therapy (bone marrow transfusion, bone peg graft, external fixation, and low intensity pulsed ultrasound) for one, as well as carpal coalition for another. The etiology of these case presentations suggest that a compression fracture of the lunate due to a DRF resulted in softening and sclerosis.

scholarly journals Difficulty in Fixation of the Volar Lunate Facet Fragment in Distal Radius Fracture

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Hiroyuki Obata ◽  
Tomonori Baba ◽  
Kentaro Futamura ◽  
Osamu Obayashi ◽  
Atsuhiko Mogami ◽  
...  
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Locking Plate ◽  
Radius Fracture ◽  
Fracture Type ◽  
Bone Fragment ◽  
Ulnar Aspect ◽  
Plate Anchor ◽  
Window Approach ◽  
Dual Window

Recent reports suggest the presence of a rare fracture type for which reduction and fixation cannot be achieved with volar locking plate (VLP). In particular, it is difficult to achieve reduction and fixation with volar lunate facet (VLF) fragments present on the volar ulnar aspect of the lunate facet, because of the anatomical structure and biomechanics in this region. Herein, we report two challenging cases of difficulty in fixation of the VLF fragment in distal radius fracture. For this fracture type, it is most important to identify the volar ulnar bone fragment before surgery; it may also be necessary to optimize distal placement of the VLP via a dual-window approach and to apply additional fixations, such as a small plate, anchor, and/or external fixation.

CORRECTIVE OSTEOTOMY FOR INTRA-ARTICULAR MALUNION OF THE SIGMOID NOTCH OF THE DISTAL PART OF THE RADIUS: A CASE REPORT

Hand Surgery ◽  
2008 ◽  
Vol 13 (02) ◽  
pp. 93-97 ◽  
Author(s):  
Chun-Ying Cheng ◽  
Chung-Hsun Chang
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Distal Part ◽  
Corrective Osteotomy ◽  
Distal Radioulnar Joint ◽  
Radius Fracture ◽  
Radioulnar Joint ◽  
Sigmoid Notch ◽  
Radiocarpal Joint ◽  
Joint Incongruity

Joint incongruity at radiocarpal joint is a common complication of the distal radius fracture, and has received much attention and study. However, the problem and outcome of treatment of intra-articular incongruity at the sigmoid notch after distal radius fracture is rarely reported. We describe a patient with deformity of the distal radioulnar joint, and impairment of supination after distal radius fracture. The evaluation of the distal radioulnar joint revealed the absence of degenerative arthritis and malunion of the sigmoid notch of the distal radius with a prominent volar lip limiting supination. We present a method of corrective osteotomy for the malunited sigmoid notch of the distal radius, to correct the incongruity of the distal radioulnar joint and restore supination.

scholarly journals Irreducible Volar DRUJ Dislocation with Distal Radius Fracture Dislocation

2019 ◽  
Vol 09 (02) ◽  
pp. 156-159
Author(s):  
Matthew T. Gulbrandsen ◽  
Jill G. Putnam ◽  
J. Tracy Watson ◽  
Michael D. McKee
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Closed Reduction ◽  
Open Reduction ◽  
Case Reports ◽  
Distal Radioulnar Joint ◽  
Fracture Dislocation ◽  
Radius Fracture ◽  
Level Of Activity ◽  
Fracture Dislocations

Abstract Background Volar dislocations of the distal radioulnar joint (DRUJ) are rare and often missed during initial evaluation. Chronic dislocations and disability can occur when DRUJ dislocations are unrecognized and not reduced. DRUJ dislocations often occur with other wrist injuries, which may complicate reduction. Closed reduction can fail to reduce DRUJ dislocations, in which case open reduction is necessary. Case Description This case describes a patient who had a volar dislocation of the DRUJ with an associated dorsal distal radius fracture dislocation. Initial attempts at closed reduction were unsuccessful which prompted surgical intervention. After open reduction and internal fixation of the distal radius fracture dislocation, closed reduction of the DRUJ remained unsuccessful. This prompted an open reduction of the DRUJ. Surgical exposure demonstrated that the extensor carpi ulnaris and the distal radius had prevented closed reduction of the DRUJ. Postoperatively, a splint was placed with the wrist in supination. The patient followed-up at the 2- and 4-month intervals with persistent subluxation. However, the patient also reported minimal pain and the ability to return to work and previous level of activity. Literature Review Current literature regarding irreducible volar DRUJ dislocations with distal radius fracture dislocations includes sparse case reports, which are reviewed in this report. Clinical Relevance This case illustrates successful treatment for an uncommon volar DRUJ dislocation associated with a dorsal distal radius fracture dislocation and can be utilized to help guide future treatment of similar complex cases.

scholarly journals Ulnar nerve injury associated with displaced distal radius fracture: Two case reports

2021 ◽  
Vol 9 (23) ◽  
pp. 6956-6963
Author(s):  
Jing-Jing Yang ◽  
Wei Qu ◽  
Yu-Xuan Wu ◽  
Hua-Jun Jiang
Keyword(s):  
Distal Radius Fracture ◽  
Nerve Injury ◽  
Ulnar Nerve ◽  
Distal Radius ◽  
Case Reports ◽  
Radius Fracture ◽  
Ulnar Nerve Injury

scholarly journals Bony Incarceration of the Extensor Pollicis Longus Tendon Mimicking Rupture

2018 ◽  
Vol 08 (03) ◽  
pp. 245-249
Author(s):  
Janos Barrera ◽  
Jessica Ryu ◽  
Jeffrey Yao
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Tendon Rupture ◽  
Case Reports ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Radius Fractures ◽  
Extensor Pollicis Longus ◽  
Tendon Entrapment ◽  
Improved Function

Background Distal radius fractures are a relatively common injury, and rupture of the extensor pollicis longus (EPL) has been known to occur in a small number of nondisplaced distal radius fractures. In contrast, bony incarceration of the EPL tendon is an exceedingly rare occurrence and warrants special attention. Case Description Here we present a case of bony incarceration of the EPL tendon following distal radius fracture that mimicked tendon rupture. Following EPL release, the patient had improved function and pain in the wrist. Literature Review We identified three case reports of EPL tendon entrapment following distal radius fracture, and compared and contrasted the clinical features of tendon rupture versus bony entrapment. Clinical Relevance Our results suggest that both the type of fracture (displaced vs. nondisplaced) and the chronicity of symptoms may provide important diagnostic clues for the hand surgeon managing distal radius fracture patients presenting with EPL dysfunction.

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