Open Peri-Implant Distal Radius Fracture Following Previous Treatment With a Dorsal Nail-Plate Device: A Case Report

Peri-implant distal radius fractures are rare but are expected to increase in incidence due to the shift from closed reduction and casting to operative fixation. The literature on distal radius peri-implant fractures is limited, with nearly all reported cases involving volar plate osteosynthesis. We report a case of an adult male who sustained a peri-implant distal radius fracture around a previously placed dorsal intramedullary nail-plate device, accompanied by an open ulnar fracture. A healthy 36-year-old right-hand-dominant male experienced this injury following a fall from a motorized scooter. During surgery, the deformity of the intramedullary device prevented fracture reduction. The device was cut, and open reduction and internal fixation were then performed using a unique approach. No complications occurred, and the patient returned to all daily activities three months after surgery. With increasing rates of operative fixation, the prevalence of peri-implant distal radius fractures is likely to rise. This case highlights the management of a peri-implant fracture involving a dorsal intramedullary nail-plate device, a scenario not previously described in the literature, and underscores the need for a tailored surgical approach.