Clin Orthop Surg.  2010 Mar;2(1):55-58. 10.4055/cios.2010.2.1.55.

Ulnar Nerve Palsy Following Closed Fracture of the Distal Radius: A Report of 2 Cases

• Cho CH
• Kang CH
• Jung JH

• KMID: 1110350
• DOI: http://doi.org/10.4055/cios.2010.2.1.55

Abstract

Ulnar nerve palsy subsequent to a fracture of the distal radius is extremely rare compared to a median nerve injury. The lesion tends to occur in younger patents with a high-energy mechanism of injury and a severe injury pattern consisting of wide displacement, comminution, combined distal ulnar fracture and open fracture. The mechanism of injury can contribute to a direct contusion and traction, compression secondary to prolonged edema and tissue fibrosis, intraneural fibrosis and laceration. We report 2 cases of progressive ulnar nerve palsy subsequent to closed fractures of the distal radius. The neurological symptoms recovered in all cases who underwent nerve decompression and neurolysis at 2 or 3 months after the trauma. It is recommended that cases with high-energy, widely displaced or comminuted fractures of the distal radius be evaluated carefully for ulnar nerve as well as median nerve injury.

Keyword

Radius fracture; Closed; Distal; Ulnar nerve; Palsy

MeSH Terms

Adult
Fracture Fixation, Internal
Fractures, Closed/*complications/surgery
Fractures, Comminuted/*complications/surgery
Humans
Male
Radius Fractures/*complications/surgery
Ulnar Neuropathies/*etiology/surgery
Young Adult

Reference

1. Bourrel P, Ferro RM. Nerve complications in closed fractures of the lower end of the radius. Ann Chir Main. 1982. 1(2):119–126.

2. Melone CP Jr. Articular fractures of the distal radius. Orthop Clin North Am. 1984. 15(2):217–236.

3. Soong M, Ring D. Ulnar nerve palsy associated with fracture of the distal radius. J Orthop Trauma. 2007. 21(2):113–116.

4. Bacorn RW, Kurtzke JF. Colles' fracture: a study of two thousand cases from the New York State Workmen's Compensation Board. J Bone Joint Surg Am. 1953. 35(3):643–658.

5. Clarke AC, Spencer RF. Ulnar nerve palsy following fractures of the distal radius: clinical and anatomical studies. J Hand Surg Br. 1991. 16(4):438–440.

6. Vance RM, Gelberman RH. Acute ulnar neuropathy with fractures at the wrist. J Bone Joint Surg Am. 1978. 60(7):962–965.

7. Zoega H. Fracture of the lower end of the radius with ulnar nerve palsy. J Bone Joint Surg Br. 1996. 48(3):514–516.

8. Cooney WP 3rd, Dobyns JH, Linscheid RL. Complications of Colles' fractures. J Bone Joint Surg Am. 1980. 62(4):613–619.

9. Kwon CS, Ahn JK, Kim JH, Sung YB, Cho JH. Fracture of the distal radius with ulnar nerve palsy. J Korean Soc Fract. 1997. 10(1):171–174.

10. Poppi M, Padovani R, Martinelli P, Pozzati E. Fracture of the distal radius with ulnar nerve palsy. J Trauma. 1978. 18(4):278–279.