Ipsilateral concomitant fractures of the distal radius and radial head: a radial Joint-Coupled Pattern (JCP).

BACKGROUND

Radius bipolar fractures are characterized by an ipsilateral combination of fractures in both the distal and proximal radius, which occur much less commonly than their separate counterparts. We propose the term Joint-Coupled Pattern (JCP) to describe this distinct injury, defined as a single bone fractured at both proximal and distal ends, thereby affecting two adjacent joints. CASE PRESENTATION: A 48-year-old female presented with right wrist pain following a motorcycle accident. Initial X-rays revealed a distal radius fracture (2R3B2, volar displacement). Open reduction internal fixation (ORIF) of the distal radius was then performed smoothly. However, she began to complain about progressive pain in her right elbow two days after the prior surgery. An X-ray confirmed a radial head fracture (Mason type II). ORIF of the radial head was promptly performed. This case exemplifies a radial JCP, involving simultaneous distal and proximal radius fractures affecting both wrist and elbow joints.

CONCLUSIONS

The JCP concept provides a framework that could potentially be extended to other long bones, allowing classification of fractures in which both proximal and distal ends are involved, thereby affecting adjacent joints. Radial JCP is an extremely rare fracture pattern. This case highlights the importance of awareness for simultaneous distal radius and radial head fractures, the potential biomechanical mechanisms, and the distinction from Essex-Lopresti injury and crisscross injury. Thorough evaluation is essential to avoid missed diagnoses and ensure timely and effective management.