Bilateral Avulsion Fractures of Extensor Carpi Ulnaris: A Case Report

Avulsion fractures of the extensor carpi ulnaris (ECU) from its insertion are rare injuries that are rarely reported in the literature. Most of the case reports detailed closed ruptures. We present avulsion fractures of the bilateral ECU from the base of the 5th metacarpal. Not much of the literature has been published in this regard.

A 33 year old male presented with pain around both wrists and hands following a fall from a bike. Following evaluation and radiological investigation, he was found to have a volar Barton fracture with an undisplaced avulsed 5th metacarpal base fracture on the right side and a displaced avulsed fracture of the left 5th metacarpal base. Internal fixation of the volar Barton fracture and mini open fixation of the left 5th metacarpal were done with a wire. The wires were removed at 6 weeks and rehabilitation started. At 3 months, the patient returned to activity with full wrist and hand function.

Bilateral avulsion fractures of the ECU from its insertion are a rare injury. Displaced fractures might benefit from surgical intervention. Early diagnosis and treatment are essential for a good functional outcome.