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Background: Distal radius fracture is a common type of bone fracture in patients of all ages. Most of the complications of this type of fracture are related to intra-articular fractures. Aim: This study aimed to compare the treatment results of distal radius fracture with two closed pinning and plate plastering methods in young patients admitted to Imam Khomeini Hospital in Jiroft in 2019. Method: The sample size was 176 patients with distal radius fractures admitted to Imam Khomeini Hospital in Jiroft in 2019. The patients were randomly divided into two treatment groups: (1) closed reduction and percutaneous pinning, and (2) plastering with plates. Finally, patients were compared in terms of the mentioned variables immediately after surgery and three months after that. The collected data were coded, entered, and analyzed by using SPSS. Results: The mean age of the selected patients in the closed pinning treatment group was 27.32 years and in the plate plastering group was 27.72 years. The minimum age of patients was four years, and the maximum was 59 years. Patients in the plate plastering treatment group seemed to have a higher mean age than those in the closed pinning treatment group, but this difference is not statistically significant ( $p>0.05$). There was no statistically significant difference between men’s and women’s ratio in terms of being in the two treatment groups ( $p>0.05$). There was no statistically significant difference between the right hand and left dominant hand ratio in the two treatment groups ( $p>0.05$). There was a statistically significant difference between the ability and disability ratio to perform the activity in the two treatment groups ( $p=0.000$). There was no significant difference between the subjective ratio of no pain, minor pain, and occasional pain in the two treatment groups ( $p>0.05$). There was a significant difference between the ratio of movement limitation less than 20%, limitation 20–50%, and limitation more than 50% in the two treatment groups ( $p=0.000$). There was a significant difference between the ratio of normal wrist strength, strength 30–60, and strength 60–90 in the two treatment groups ( $p=0.000$). There was no statistically significant difference between the uncomplicated ratio and partial crepitation in terms of placement in the two treatment groups ( $p>0.05$). Finally, there was no statistically significant difference between the total score ratio, closed pinning, and plate plastering treatment groups ( p>0.05). Conclusion: According to this study results, there is no difference between the two treatment methods of closed pinning and plastering with a plate. However, the pinning treatment group had the highest frequency of excellent scores than the plate plastering method.

Distal radius fractures with concomitant ipsilateral elbow dislocation are a rare injury pattern. Only a few cases of a distal radius fracture with ipsilateral elbow dislocation have been reported. We discuss the case of a 46-year-old gentleman presenting with posteromedial elbow dislocation with an ipsilateral closed extra-articular fracture of the distal radius. Plain radiographs showed a right posterior-medial elbow dislocation and ipsilateral distal radius fracture. CT scans of the elbow showed impaction fractures of the coronoid and trochlea, suggesting a concomitant posteromedial varus elbow dislocation injury. CT scans of the wrist showed the presence of a comminuted, extra-articular distal radius fracture. Surgical fixation of the distal radius was performed, as well as repair of the right elbow lateral capsule-ligamentous complex with suture anchors. Proper recognition of the posteromedial varus instability type injury to the elbow, as in this case is important, should be addressed. If VPMRI is missed, it can lead to ulno-humeral osteoarthritis of the elbow joint.

Background: The statistical concept of minimal clinically important difference (MCID) enables the interpretation of small but meaningful changes that result from an intervention. This retrospective study aimed to examine the factors that influence the achievement of MCID after a distal radius fracture.

Methods: A total of 45 patients (mean age: 54.2 ± 16 years) were included. Of these, 27 patients started rehabilitation within 3 days of surgery (Early group), and 18 patients underwent immobilization for 2 weeks after surgery, before starting rehabilitation (Non-early group). Functional outcomes and DASH scores at 4 weeks (baseline) were compared with those measured at 8 and 12 weeks for both groups, to determine whether the MCID had been achieved.

Results: Our results showed that at 8 weeks after surgery in the early group, the grip strength, ulnar flexion, and baseline DASH score were significantly different between the groups that did and did not show an MCID ($p<0.05$). There was also a significant difference in the baseline DASH score at 12 weeks after surgery ($p<0.05$). None of these factors were significant in the non-early group. Logistic regression analysis revealed that the DASH score at 4 weeks (baseline) was an independent predictor for achieving a DASH MCID at 8 weeks postoperatively in the early group (odds ratio: 1.193). Those achieving a DASH MCID at 12 weeks postoperatively were completely separated by the baseline DASH score (≥ 29 points).

Conclusions: If it is assumed that the effectiveness of rehabilitation depends upon achieving the DASH MCID by promoting functional recovery, early initiation might be recommended.

A fracture of the distal radius with an associated injury to the ulnar nerve is rare. The management of the ulnar nerve lesion is unclear. We present a patient with a closed distal radius fracture related to an injury to the ulnar nerve associated with diminished sensation and a claw deformity. This was assessed by ultrasonography (US) that showed the nerve to be in continuity without any evidence of compression. The nerve was deviated towards the volar side at the distal end of the ulna and was enlarged at the same point. Open reduction and internal fixation was performed for the fracture. Emergent nerve exploration was not performed. The function of the ulnar nerve was completely restored at 16 weeks after injury. In cases presenting with ulnar nerve injury, we recommend US to evaluate the condition of the ulnar nerve. Nerve exploration should be performed when neurological deficits were found on US or symptoms did not recover over 4 months observation.

Level of Evidence: Level V (Therapeutic)