Unfortunately, after surgery, the patient complained of a continuous tingling sensation in the medial half of the ring finger and the little fingers, which gradually worsened. The wrist was immobilized with a short arm cast. The ulnar styloid fracture did not undergo internal fixation, and the ulnar nerve was neither explored nor released. The bone deficiency in the radial metaphysis was treated with an allogeneic cancellous bone graft. One day after the injury, the patient underwent open reduction and internal fixation through a standard volar approach (Henry approach), using a standard volar locking plate (Acumed, Hillsboro, OR, United States) (Figure 1C and D). Some authors have reported that careful observation can lead to recovery, while others have reported that rapid recovery could be obtained with early decompression. However, there is some controversy regarding the need for early nerve exploration of an ulnar nerve injury in a closed fracture. Initial treatment of acute ulnar nerve compression subsequent to a fracture of the distal radius is reduction of the fracture fragments. However, Soong and Ring encountered ulnar nerve palsy in 5 adults with high-energy, widely displaced, distal radius fractures during a 2-year period, suggesting that this combination of injuries may be more common than previously recognized. Bacorn and Kurtzke reported only one case of ulnar nerve injury (0.05%) in 2000 patients with fracture of the distal radius. Ulnar nerve injury subsequent to a fracture of the distal radius is extremely rare compared to median nerve injury. Fracture of the distal radius may be complicated by injuries to these structures. The median, ulnar and radial nerves cross the wrist to innervate the hand.
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