Jammed ulnar nerve after distal radius fracture: A case report

BACKGROUND: Ulnar nerve lesions represent a rare complication of wrist fracture. The present manuscript describes the case of a particular traumatic mechanism in which the nerve resulted crushed between radial fracture fragments. CASE PRESENTATION: A 47-year-old man suffered a subtotal lesion of the ulnar nerve following an open displaced distal radius fracture. Symptoms of ulnar nerve deficiency worsened after reduction and temporary stabilization. Further surgery was performed to achieve definitive stabilization and ulnar nerve neurolysis. The ulnar nerve was found to be jammed inside the fracture side, and so was repaired with a direct suture. Progressive recovery was observed in the following months. CONCLUSIONS: Given the paucity of reports of ulnar nerve injury in the literature, clear recommendations for treatment of nerve lesions after wrist fractures have not yet been defined. Nevertheless, in our experience, peripheral nerve function should be assessed before and after fracture reduction, as a worsening of symptoms after surgical intervention could indicate nerve entrapment inside the fracture site.