Orthopedic hardware impingement - wrist

Case contributed by Dr Maulik S Patel

Presentation

History of intramedullary nail fixation across a left radius-ulna fracture about 2 years ago. Complaining of dorsal wrist pain and swelling for the last few weeks. No recent trauma.

Patient Data

Age: 55 years
Gender: Female

There is intramedullary nail fixation across healed fracture of radius and ulna shaft. There is no dislocation or recent fracture. There is no bone lesion.

Ultrasound

About 10 mm length of the radial nail is outside the distal end of the radius at the wrist dorsum. This nail is impinging extensor carpi radialis longus tendon with wrist flexion. There is no impingement with the neutral position of the wrist. There is an effusion with echoes in the 2nd and 3rd extensor compartment synovial sheaths without tendon tear. The nail is causing reverberation artifact.

Case Discussion

Findings favor soft tissue impingement at the wrist due to an intramedullary nail in the radius with extraosseous extension. There is tenosynovitis involving the 2nd and 3rd extensor compartments.

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Case information

rID: 63154
Published: 20th Sep 2018
Last edited: 21st Sep 2018
Inclusion in quiz mode: Included

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