Median and ulnar neuropathy after distal radius fractures: a narrative review and illustrative case presentation

Abstract

Distal radius fractures (DRFs) are very common fractures and can result in additional nerve injuries. Median nerve lesions occur more frequently than ulnar nerve injuries, with reported incidences ranging from 0.2% to 32%. Studies on ulnar nerve injuries are limited to case reports or very small case series. Dorsal angulated fractures, open fractures, and high-impact injuries are particularly associated with a high risk of nerve injuries. The optimal management and timing of treatment for patients with nerve pathology following DRF remain unclear. Clinically distinguishing between the various types and causes of nerve injuries in the acute phase can be very challenging, making close monitoring of these patients crucial. To provide a current overview of this important issue, we reviewed the literature regarding median and ulnar nerve injuries secondary to DRFs, with a special focus on treatment strategies and timing. In addition, an illustrative case of ulnar nerve injury after a DRF is presented. In this case, the ulnar nerve was translocated between the fractured parts of the distal radius. Surgical exploration and relocation of the nerve, along with fracture stabilization 8 days after the trauma, resulted in improved sensorimotor function at a 16-month follow-up.

Keywords

Distal radius fracture / nerve injury / median nerve / ulnar nerve / neuropathy / treatment strategy

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