Department of Hand and Reconstructive Microsurgery, Tan Tock Seng Hospital, Singapore.
J Hand Surg Asian Pac Vol. 2024 Jun;29(3):225-230. doi: 10.1142/S2424835524500243. Epub 2024 May 10.
Ulnar neuropathy after a distal radius fracture is rare and has limited reports in literature. As such, there is no consensus regarding the optimal treatment and management of such injuries. We report our experience with managing these uncommon injuries. A retrospective review was conducted where patients presenting with ulnar neuropathy after sustaining a distal radius fracture were identified from January 2021 to December 2023 from our hospital database. A total of four patients were identified. All of them underwent surgical fixation for their respective fractures. None of them underwent immediate or delayed exploration and decompression of the ulnar nerve. All patients had clinical improvement at 3 months after their initial injuries. Three patients eventually had resolution of the neuropathy between 5 and 9 months post injury, while one had partial recovery and developed a neuroma but declined surgery due to symptoms minimally affecting work and daily activities. Ulnar neuropathy after distal radius fractures may not be as rare as previously thought. Expectant management of the neuropathy would be a reasonable treatment as long as there is no evidence of nerve discontinuity or translocation and that there is clinical and/or electrodiagnostic improvement at 3-4 months after the initial injury. Level IV (Therapeutic).
尺神经病变在桡骨远端骨折后并不常见，文献中的报道也有限。因此，对于这类损伤的最佳治疗和管理方法尚未达成共识。我们报告了我们在处理这些不常见损伤方面的经验。
我们进行了一项回顾性研究，从 2021 年 1 月至 2023 年 12 月，从我们医院的数据库中确定了因桡骨远端骨折而出现尺神经病变的患者。共确定了 4 名患者。他们各自的骨折均接受了手术固定。他们均未立即或延迟探查和减压尺神经。所有患者在初次受伤后 3 个月均有临床改善。3 名患者最终在受伤后 5 至 9 个月时神经病变得到缓解，1 名患者部分恢复并出现神经瘤，但由于症状对工作和日常生活的影响极小而拒绝手术。
桡骨远端骨折后出现的尺神经病变可能并不像以前认为的那样罕见。只要没有神经连续性中断或移位的证据，并且在初次损伤后 3-4 个月有临床和/或电诊断改善，期待性治疗神经病变将是一种合理的治疗方法。
IV 级（治疗）。
