Radius-ulna shaft fracture with distal radioulnar joint instability in a case of ipsilateral malunited colles fracture: a case report

Abstract

<p class="abstract">Malunion of the distal end of radius is a known consequence of the conservative management. The functional impairment depends on the severity of the deformity and it can be associated with distal radioulnar joint (DRUJ) instability. Subsequent radius ulna fracture in an elderly osteoporotic patient is a challenging task to manage. A 60 year old female patient came with radius ulna shaft fracture with DRUJ instability with ipsilateral malunited distal radius fracture. We managed with open reduction and internal fixation using 3.5 mm locking compression plate (LCP) with ulnar shortening and K wires for DRUJ. At one year, follow-up, patient is having good clinical and radiological outcome without any complications. Radius ulna shaft fracture in cases of malunited colles fracture with positive ulnar variance with DRUJ instability can be managed well with open reduction and internal fixation of radius-ulna shaft which provides stable fixation, ulnar shortening at the fracture site to maintain the neutral/negative ulnar variance and DRUJ fixation using K wires. Use of multiple vicryl sutures to tie the plate to the bone gives additional stability in osteoporotic bones till the fracture unites and prevents implant failure. Combination of the above mentioned procedures helps in getting good functional outcome in elderly osteoporotic patients.</p>