PMC6035807_01
The forearm skin state on her visit to our hospital. Skin disorder accompanied by blister formation was observed on the right forearm. The blistering was present along the splint application area.
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The blister was observed along the splint application area (Figure 1) and was considered to be due to the heat and stuffiness of the splint.
Plain X-ray films on her visit to our hospital. (a) Frontal plain X-ray image. (b) Lateral plain X-ray image. Plain X-ray images showed a distal radius fracture accompanied by dorsal displacement of the distal bone fragment. Due to the skin state, conservative treatment by external fixation, such as splinting and casting, was difficult. Surgery after improvement of the skin state was considered to be more invasive due to bone union. Therefore, osteosynthesis using a minimally invasive approach was planned.
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Plain X-ray examination revealed a distal radius fracture accompanied by dorsal displacement of the distal bone fragment (AO classification: type A2) (Figures 2(a) and 2(b)).
Findings during operation. (a) Skin incision design. This surgical technique could be performed because there was no skin lesion at the skin incision site. (b, c) Volar locking plate fixation. After reduction of the distal bone fragment using a Kirschner wire, osteosynthesis was performed using a volar locking plate (Acu-Loc 2 proximal plate standard, Nihon Medical Next, Osaka, Japan). (d, e) Plain X-ray images after volar locking plate fixation ((d): frontal image, (e): lateral image). Fixation in a favorably reduced position is observed.
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In this patient, there was no skin lesion at this incision site, which allowed this surgical technique (Figure 3(a)). After reduction of the distal bone fragment using a Kirschner wire, osteosynthesis was performed using a volar locking plate (Acu-Loc 2 proximal plate standard, Nihon Medical Next, Osaka Japan) (Figures 3(b) and 3(c)). After the operation, a favorable alignment was obtained (Figures 3(d) and 3(e)).
Forearm skin state 6 months after the operation. The forearm skin state and surgical wound favorably improved, and she returned to her preinjury job without any problems in daily life.
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The state of the forearm skin and surgical wound favorably improved (Figure 4), and she returned to her preinjury job.