Functional outcome in case of surgically and conservatively treated bilateral distal end radius and scaphoid fracture: a rare case report

Abstract

Bilateral fractures of the distal radius and scaphoid are extremely rare injuries. Proper preoperative evaluation is a must to know the orientation of the fracture. Treatment must be based on displacement of the fracture. If fracture is displaced, internal fixation is needed but if its stable with minimal displacement, we can conserve it. A patient with displaced distal radius fractures and displaced scaphoid fracture on one side, along with displaced distal end radius fracture and undisplaced scaphoid fracture on the other side, was treated via internal fixation of the scaphoid fractures with Herbert screws and internal fixation of the distal radius fractures with locked volar plating on the right side and below elbow cast in cup holding position on the left side which was non-dominant. The approach to treating fractures hinges on several factors: the specific location and alignment of the fracture, the patient's characteristics, and the surgeon's expertise. For fractures in the distal radius and scaphoid, employing a rigid internal fixation method allows for the early initiation of active wrist rehabilitation, eliminating the necessity for wrist immobilization using a plaster cast or external skeletal fixation. On the other hand, a conservative treatment approach involving a below-elbow cast offers certain advantages, such as minimal blood loss and fewer complications related to wound healing, particularly for undisplaced fractures, especially when they occur in the non-dominant hand.