Distal radius fracture after proximal row carpectomy

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Traumatology

Background:

• Proximal row carpectomy (PRC) is a surgical procedure for wrist conditions like Kienböck disease.
• Distal radius fractures (DRF) are common orthopedic injuries.
• The biomechanics of the wrist after PRC can be altered, potentially influencing fracture patterns.

Purpose of the Study:

• To report a case of distal radius fracture (DRF) occurring after proximal row carpectomy (PRC).
• To discuss the potential mechanism of DRF in the context of altered wrist biomechanics following PRC.

Main Methods:

• Case presentation of a 73-year-old female with a history of PRC.
• Analysis of the fracture type (extra-articular DRF) and timing (3 years post-PRC).
• Description of surgical management (volar locking plate osteosynthesis) and outcomes (Mayo score, functional recovery).

Main Results:

• The patient sustained an extra-articular distal radius fracture three years after undergoing proximal row carpectomy.
• Surgical fixation with a volar locking plate was successful, with no postoperative complications.
• Excellent functional outcomes were noted at six months post-surgery, with recovery of daily living activities.

Conclusions:

• PRC alters wrist biomechanics, potentially leading to abnormal pressure distribution on the distal radius.
• This altered pressure may predispose the distal radius to fracture, particularly with dorsal loading.
• The mechanism of distal radius fracture may differ in patients who have previously undergone PRC.