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

Affiliations
  • 1Department of Orthopaedic Surgery, Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Korea. oscho5362@dsmc.or.kr

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

  • 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.

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

  • 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.

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


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.
Article
3. Soong M, Ring D. Ulnar nerve palsy associated with fracture of the distal radius. J Orthop Trauma. 2007. 21(2):113–116.
Article
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.
Article
6. Vance RM, Gelberman RH. Acute ulnar neuropathy with fractures at the wrist. J Bone Joint Surg Am. 1978. 60(7):962–965.
Article
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.
Article
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.
Article
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.
Article
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