Treatment of fractures of the proximal radial diaphysis: case report

Prikazujemo slučaj 20-godišnjeg pacijenta s frakturom dijafize proksimalnog radiusa, uz angulaciju (AO-22-A2.2), liječenog kirurški dorzolateralnim pristupom, otvorenom repozicijom i osteosintezom s LC-DC pločom i kortikalnim vijcima, uz solidnu interfragmentarnu kompresiju. Cilj ovoga prikaza slučaja je ukazati na anatomsku i kiruršku složenost ove regije i moguću komplikaciju intraoperacijske lezije duboke grane radijalnog živca. Ovaj tip prijeloma nije čest i u odrasloj dobi liječi se operacijski u cilju uspostave uredne funkcije lakatnog i ručnog zgloba. Posebnost regije proksimalnog radiusa je u anatomskoj poziciji duboke grane nervusa radialisa koji prolazi kroz muskulus supinator. I uz dobru identifikaciju duboke grane nervus radialisa i nervus interosseuma dorsalis, njihove intraoperacijske lezije nisu rijetke, kao što prikazujemo i u ovom slučaju.Reported is the case of a 20 year-old male with AO-22-A2.2 fracture of the proximal radial diaphysis with angulation, treated by dorsolateral approach, open reposition and osteosynthesis with LC-DC plate and cortical screws with solid interfragmental compression. The aim of this case report is to illustrate the anatomical and surgical complexity of this region that may contribute to operative injury of the deep branch of the radial nerve. This type of fracture is not common and requires surgical procedure in adults in order to restore the proper function of the elbow and wrist. The position of deep branch of the radial nerve which passes through the supinator muscles is characteristic for the proximal radial region. Despite of good identification of the deep branch of the radial nerve and dorsal interosseus nerve, their intraoperative injury in not uncommon as illustrated in this case