Severely comminuted radius fracture presenting as a signature patterned injury - PubMed
Severely comminuted radius fracture presenting as a signature patterned injury
Saurabh Jain et al. Indian J Orthop. 2016 Mar-Apr.
Abstract
Dilemma still prevails, regarding the exact management of mangled extremity injuries between limb salvage versus amputation, each having there own set of complications. We here present a case of severely comminuted fractures of radius (bag of bones) along with the multiple criss-cross shaped lacerated wounds on the forearm and wrist presenting as a "signature pattern injury" caused by entrapment of the limb in the concrete mixer. MESS score of patient was 8, a score valid for amputation, but contrary, we successfully salvaged the patient's limb with use of radio-carpal distracter. Management of mangled injuries should be individualized, with due consideration to the mechanism and force of injury, associated injuries, and the patient profile.
Keywords: Bag of bones; Radius fractures; bone; fracture fixation; fractures; radius; severely comminuted fracture; signature patterned fracture.
Conflict of interest statement
Conflict of Interest: None.
Figures
Preoperative anteroposterior (AP) (a) and lateral (b) X-ray of forearm with wrist and AP (c) X-rays of hand with wrist of the patient showing severely comminuted middle and distal radius fracture (bag of bones), with intraarticular extension with fracture 1st and 2nd metacarpal, with crushed thumb and severely comminuted fracture of the proximal and distal phalanx of the thumb and intact ulna and carpals and maintenance of the inter carpal relation
Immediate postoperative anteroposterior (a) and lateral (b) X-ray of the forearm with wrist showing application of the radio-carpal distracter
Anteroposterior (a) and lateral (b) X-ray at final followup (7 months) showing sound union. (c and d) Clinical photographs of the patient showing functional outcome (e and f) Clinical photograph showing palmar-flexion and dorsi-flexion
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