Case summary
Fracture treated conservatively (February 2022).
One-week follow-up showed loss of height and mild TILD with neutral tilt.
The patient wore a forearm cast for 4 weeks (FEDR). A CT scan of the left wrist was performed, including axial views and coronal/sagittal reconstructions. The scan revealed:
- Comminuted fracture with impaction of the distal radius and ulnar displacement of the posterior-lateral cortical fragment
- Non-displaced fracture of the ulnar styloid process
- Generalized osteopenia
- No intra-articular loose bodies
- Subchondral sclerosis with cysts in the distal ulna
- Scaphotrapezoid degenerative changes with an intraosseous ganglion in the distal scaphoid
- Mild rhizarthrosis
- No other significant findings
Due to the complexity of the deformity, a full 3D study was requested, and the EXCELLENCE solution (3D planning + custom cutting guide + patient-specific implant) was selected.
Surgery date: October 7, 2022
Final follow-up: May 17, 2023
- Full pronation-supination preserved
- Flexion 55° / Extension 65°
- No pain
Preoperative
During surgery
Immediate postoperative
3-month follow-up
6-month follow-up
