Author(s): Raquel Ricardo, Cláudia Santos, Nádia Oliveira, Filipe Santiago Castelo, Bárbara Costa and Ricardo Reis de Sousa

Abstract: The distal radioulnar joint (DRUJ) is an integral part of the structures necessary for performing the movements of pronation and supination of the forearm, wrist, and hand. Any alteration affecting this structure will lead to an imbalance in the kinetics of the wrist and forearm, resulting in limitations in the patient's daily life activities. We report a rare case of an isolated intra-articular fracture of the head of the ulna, which has been poorly described in the literature, as well as the treatment instituted. A 20-yer-old healthy woman, who presented to the Emergency Department after a fall, that resulted in clinical symptoms of pain, swelling, and functional impairment of the left wrist. Wrist X-rays revealed an isolated distal ulnar fracture. A Computed Tomography scan confirmed an intra-articular fracture with dorsal displacement.The patient underwent surgical treatment with Wide Awake Local Anesthesia No Tourniquet (WALANT). Open reduction and fixation with two Herbert-type cannulated screws was performed through a dorsal approach. Stability of the DRUJ was confirmed by a dynamic assesment after fracture fixation, which could be assessed dynamically because the use of WALANT. The patient was immobilized in a sugar tong splint for 6 weeks. At that point, the patient had limitations in pronosupination. At 3 months postoperatively, the patient had complete range of motion. In the research conducted up to April 2022, we found only six published cases, and the incidence of this type of fracture is not well documented. Currently, there are no guidelines or consensus regarding the mechanism of injury or the treatment to be instituted, as the different cases have varied considerably.

DOI: 10.22271/27078345.2023.v5.i2b.179

Pages: 67-70 | Views: 160 | Downloads: 69

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