Mahajan Neetin P, Kondewar Pranay, G S Prasanna Kumar, Sadar Amey, Atal Shubham
Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India.
J Orthop Case Rep. 2021 Jul;11(7):37-40. doi: 10.13107/jocr.2021.v11.i07.2306.
Unilateral isolated ulna fracture secondary to trauma are common but the bilateral nightstick fractures are quite rare in the clinical scenario. These are managed conservatively or surgically depending upon the degree of displacement, location of the fracture, fracture pattern and associated injury to other bones. Proper management of these fractures helps in getting a better outcome. The purpose of the study was to present a case of bilateral traumatic isolated ulna fracture and its management.
A 33-year-old male presented to the emergency department with complaints of pain and swelling over the dorsum of both forearms with a history of assault with a bamboo stick. The mechanism of the injury was, the patient placed his both the forearms in front of the face as a defense during the assault and sustained injury to both forearms. On examination, the patient had bilateral forearm swelling with tenderness. Bony crepitus was present over both the ulna on palpation. X-ray of both forearms (radius and ulna) revealed the fracture of both right and left ulna without any associated fractures/injuries. The patient was managed surgically with open reduction and internal fixation using a 3.5 mm locking compression plate. At present, 1-year follow-up, the patient is having complete wrist, elbow ROM and supination, pronation without any pain.
Bilateral traumatic Nightstick fractures of the ulna are rare and this is the first reported case of traumatic bilateral isolated ulna fracture according to author's best knowledge and literature review. Open reduction and stable internal fixation using the principles of fracture fixation along with early mobilization helps in getting better functional outcome and prevents further complications and secondary procedures. This case is unique as it helps in identifying the mode of trauma in medico legal cases like assault in cases of bilateral ulna fracture. The mode and the mechanism of injury are different in this case.
创伤继发的单侧孤立性尺骨骨折很常见，但双侧警棍骨折在临床中相当罕见。根据移位程度、骨折位置、骨折类型以及其他骨骼的相关损伤情况，可采用保守或手术治疗。对这些骨折进行恰当处理有助于获得更好的治疗效果。本研究的目的是报告一例双侧创伤性孤立性尺骨骨折及其治疗情况。
一名33岁男性因双前臂背侧疼痛和肿胀就诊于急诊科，有被竹棍袭击的病史。损伤机制为，患者在袭击过程中将双前臂置于面部前方进行防御，导致双前臂受伤。检查时，患者双前臂肿胀且有压痛。触诊时双侧尺骨均有骨擦感。双前臂（桡骨和尺骨）X线显示双侧尺骨骨折，无任何相关骨折/损伤。患者接受了手术治疗，采用3.5毫米锁定加压钢板进行切开复位内固定。目前，随访1年，患者腕关节、肘关节活动范围完全正常，旋前、旋后功能正常，无任何疼痛。
双侧创伤性尺骨警棍骨折罕见，据作者所知及文献回顾，这是首例创伤性双侧孤立性尺骨骨折报告。遵循骨折固定原则进行切开复位和稳定的内固定，并早期活动，有助于获得更好的功能结果，预防进一步并发症及二次手术。该病例独特之处在于，它有助于在涉及双侧尺骨骨折的袭击等法医案件中识别创伤方式。此病例的损伤方式和机制有所不同。
