Unusual Forearm Injury

Abstract

A 42-year-old migratory laborer presented to the emergency department with an alleged history of being hit by a bull on his right forearm and a subsequent fall. On examination, he had a compound fracture with a small bleeding wound (2 × 1.5 cm) over the postero-medial upper part of the forearm and a part of broken bone protruding through it. There was diffuse tenderness, swelling tenderness, and bony crepitus felt. There was no distal neurovascular deficit. Radiographs of his right arm and forearm with shoulder, elbow, and wrist joints revealed a segmental fracture of the proximal ulna at the upper part along with anterior radial head dislocation. There was an associated distal radius fracture ipsilaterally. Under general anesthesia, using the dorsal approach, the wound was thoroughly debrided. In the same sitting internal fixation with a contoured plate of ulna, reduction of radial head, and closed fixation of the distal radius fracture was done using square nails. Postoperatively, the forearm was immobilized in an above elbow slab in 100 degrees of flexion. The sutures were removed at two weeks and recovery was uneventful. At six weeks, physiotherapy with range of movement was started and the patient was moved back to his original place and lost to follow-up.

Keywords