A rare case report of bilateral distal radius fractures including bilateral isolated metacarpophalangeal joint dislocations in a piano artist
International Journal of Orthopaedics Sciences
Bilateral distal radius fractures are rare injuries and only a small number of case reports exist. Literature reports of low velocity as well as high velocity injuries. It has been found that high velocity injuries are frequently associated with injury to carpals, metacarpals and phalanges. No case has yet been reported in medical literature with respect to bilateral distal radius fractures associated with bilateral single finger Metacarpophalangeal (MCP) joint dislocation. The aim of this case
... report is to emphasize the rarity of this injury and the associated trauma which are sometimes missed or diagnosed late. This case also highlights the role of skilful urgent reduction and stabilisation of such injuries followed by an early aggressive hand and wrist rehabilitation program to ensure an excellent outcome for the patient. Case Report: We report a case of bilateral distal radius fracture with MCP joint dislocation of the right index finger and MCP joint dislocation left thumb in a professional pianist following a high energy trauma due to a road traffic accident. The patient underwent surgery in the form of closed reduction and a wrist spanning radial distractor application with pinning of bilateral wrist. Closed reduction was done for the MCP joint dislocation left thumb and open reduction for the MCP joint dislocation right index finger. Patient was on an aggressive physiotherapy regime from the early postoperative period. Both the distal radius fractures united adequately by three months as well as the MCP joint dislocations restored with a satisfactory DASH functional scores. Conclusion: High energy traumas to the hand and wrist can result in ipsilateral or even bilateral injuries of the distal radius, ulna, carpals, metacarpals and phalanges. Hence, it is important not to miss any associated injury in the small bones of the hand when there is a fracture in the forearm and arm bones. Initiation of an early and intense rehabilitation program requires immediate reduction and fixation of the fractures and dislocations in order to gain the best functional outcome for the patient.