A case report of an isolated fracture through the radial bicipital tuberosity. (2017)

• Record Type: Journal Article
• Authors: Imao, Kanta; Miwa, Hitoshi; Watanabe, Kazutoshi; Imai, Norio; Endo, Naoto
• Is Part Of: International journal of surgery case reports. Volume 41(2017)
• Page Start: 230
• Page End: 233
• Publication Date: 2017
• Subjects: PIN posterior interosseous nerve -- IM intramedullary; Radial bicipital tuberosity -- Posterior approach -- Posterior interosseous nerve -- Shaft fracture; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2017.10.037
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: An isolated fracture through the radial bicipital tuberosity is rare. The posterior approach has lower complication and is suitable for this fracture. IM nailing is not recommended in fractures through the radial bicipital tuberosity. Abstract: Introduction: Generally, anatomical reduction of shaft fractures through operative treatment is necessary to restore the anatomical relationship of the forearm bones. However, a number of nerves and vessels are located in the proximal radius, which complicates surgery. In this study, we aimed to reduce postoperative complications by using a posterior approach. Presentation of case: We describe an isolated fracture through the radial bicipital tuberosity in a 69-year-old man caused by direct blunt force and our management of the fracture. The patient underwent an operation for the fracture under brachial plexus block. The injury was explored using the posterior approach, and plate fixation was performed after confirming the absence of obstacles to rotation on pronation and supination. One year later, the patient did not have any difficulties in activities of daily living. Discussion: Since an isolated fracture through the radial bicipital tuberosity is more distal than the radial head and neck and more proximal than a common radius diaphysis fracture, we had to consider a different operative approach. The nerve and blood vessels of the forearm, such as the radial nerve and artery, run in a complicated fashion around the proximal radius; thus, we chose the posterior approach because of its simpler surgical technique and lower complication risk, compared with the anterior approach. Conclusion: Surgeons can obtain a favorable treatment result using the posterior approach to the fracture and reduce complications by ensuring with rigid fixation using a locking plate.