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Open distal radius fracture with ulnar neurovascular injury treated with dorsal spanning plate fixation and vein interposition grafting: a case report
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Kyeong-Eon Kim, Ho-Yong Lee, Shin-Woo Lee, Ji-Sup Kim
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J Musculoskelet Trauma 2026;39(3):262-268. Published online July 20, 2026
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DOI: https://doi.org/10.12671/jmt.2026.00164
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 Abstract
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- Open comminuted intra-articular distal radius fractures with associated ulnar neurovascular injury are rare; furthermore, these injuries are challenging because skeletal stabilization, arterial reconstruction, nerve assessment, and soft-tissue coverage must be coordinated. We report the case of an 80-year-old female patient who presented after a fall from stairway with a severe open distal radius fracture and a volar-ulnar distal forearm wound. She reported numbness and tingling in the ring and small fingers, with a cold sensation and delayed capillary refill. Imaging showed a severely comminuted intra-articular distal radius fracture (AO/OTA type 23-C3). Emergency surgery was performed within 6 hours. First, a dorsal spanning plate was applied, and the small volar lunate facet fragment was fixed with a volar lunate facet plate. After debridement of the injured ulnar artery, a segmental defect remained and was reconstructed using a reversed basilic vein interposition graft harvested from the ipsilateral proximal forearm. The contused but continuous ulnar nerve was treated with neurolysis. The soft-tissue defect was managed with an acellular dermal matrix and negative-pressure wound therapy, followed by staged full-thickness skin grafting 1 week later. At 1 year postoperatively, bony union was achieved, and the functional outcomes were satisfactory.
Level of evidence: V.
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