Department of Orthopaedic Surgery, Suwa Central Hospital, Nagano, Japan.
Department of Rehabilitation Medicine, Suwa Central Hospital, Nagano, Japan.
J Hand Surg Asian Pac Vol. 2022 Apr;27(2):408-412. doi: 10.1142/S2424835522720195. Epub 2022 Apr 19.
A fracture of the distal radius with an associated injury to the ulnar nerve is rare. The management of the ulnar nerve lesion is unclear. We present a patient with a closed distal radius fracture related to an injury to the ulnar nerve associated with diminished sensation and a claw deformity. This was assessed by ultrasonography (US) that showed the nerve to be in continuity without any evidence of compression. The nerve was deviated towards the volar side at the distal end of the ulna and was enlarged at the same point. Open reduction and internal fixation was performed for the fracture. Emergent nerve exploration was not performed. The function of the ulnar nerve was completely restored at 16 weeks after injury. In cases presenting with ulnar nerve injury, we recommend US to evaluate the condition of the ulnar nerve. Nerve exploration should be performed when neurological deficits were found on US or symptoms did not recover over 4 months observation. Level V (Therapeutic).
桡骨远端骨折伴尺神经损伤少见。尺神经损伤的处理并不明确。我们报告了一例闭合性桡骨远端骨折合并尺神经损伤的患者，表现为感觉减退和爪形畸形。超声（US）检查显示神经连续，无明显受压。尺神经在尺骨远端向掌侧偏斜，同一部位神经增粗。骨折行切开复位内固定。未行急诊神经探查。损伤后 16 周，尺神经功能完全恢复。对于出现尺神经损伤的病例，我们建议行 US 评估尺神经情况。如果 US 发现神经功能缺损，或症状在观察 4 个月以上仍未恢复，应行神经探查。 5 级（治疗）。
