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Die-punch fracture

Case contributed by Bálint Botz
Diagnosis certain

Presentation

Distal radius fracture confirmed by radiographs elsewhere, preoperative evaluation.

Patient Data

Age: 25 years
Gender: Male
ct

An impressed fracture of the distal radial articular surface is clearly visible. Note the resultant negative ulnar variance. 

Postoperative follow-up

x-ray

Status post fixation with volar locking plate. Absence of negative ulnar variance. 

Case Discussion

Die-punch fractures are typically the result of high-energy axial loading forces. Due to the widespread involvementof the articular surface operative management remains the mainstay of their therapy. 

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