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

Figure

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  Fig. 1 Anteroposterior and lateral radiographs show an intra-articular fracture of the distal radius with a fracture of the ulnar styloid process. The distal fragment of the radius was displaced dorsoradially.

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  Fig. 2 Photograph shows swelling, compression and adhesion by the surrounding tissue fibrosis of the ulnar nerve at the level of Guyon's canal.

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  Fig. 3 Anteroposterior and lateral radiographs show a severe intra-articular comminuted fracture of the distal radius with a fracture of the ulnar styloid process.

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  Fig. 4 Photograph shows swelling and compression by the surrounding tissue fibrosis of the ulnar nerve at the level of Guyon's canal.

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