Fixation of Distal Ulna Fractures Associated with Distal Radius Fractures Using Intrafocal Pin Plate

Background: The purpose of this study was to report outcomes in patients with nonstyloid distal ulna fractures treated in conjunction with open reduction internal fixation (ORIF) of distal radius fractures. Methods: A retrospective review of all patients who had undergone ORIF of a distal radius fracture over a 5-year period at a single institution was performed. Radiographic review was performed to identify patients with a concomitant fracture of the distal ulna. Radiographs were examined to determine whether and how the distal ulna fracture was stabilized and to assess healing of the distal ulna. Range of motion (ROM) was determined by review of the patients’ charts. All skeletally mature patients with distal ulna fractures (not including isolated styloid fractures) undergoing surgical fixation of the distal radius fracture were included. Patients were excluded if follow-up was inadequate. There were 172 fractures of the distal ulna meeting the inclusion criteria. Seven patients were excluded. There were 91 patients treated without ulna fixation (ulna-no) and 74 patients treated with ulna fixation (ulna-yes). Results: Seventy-two (97%) of the ulna-yes patients healed. All patients in the ulna-no group healed. The only significant difference in ROM was in pronation, although the magnitude of this difference was relatively small. Conclusions: Fractures of the distal ulna have high rates of healing and result in equivalent motion regardless of whether the distal ulna is treated operatively. Routine surgical fixation of concomitant distal ulna fractures during distal radius ORIF does not appear to be necessary.

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Intrafocal Pin Plate Fixation of Distal Ulna Fractures Associated With Distal Radius Fractures

Yearbook of Hand and Upper Limb Surgery ◽

10.1016/j.yhls.2012.04.006 ◽

2012 ◽

Vol 2012 ◽

pp. 8-9

Author(s):

J. Adams

Keyword(s):

Distal Radius ◽

Plate Fixation ◽

Distal Radius Fractures ◽

Radius Fractures ◽

Distal Ulna ◽

Ulna Fractures

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Technique for Intramedullary Stabilization of Ulnar Neck Fractures

Hand ◽

10.1177/1558944717725376 ◽

2017 ◽

Vol 13 (5) ◽

pp. 563-571

Author(s):

Jack Abboudi ◽

Scott M. Sandilands ◽

C. Edward Hoffler ◽

William Kirkpatrick ◽

William Emper

Keyword(s):

Distal Radius ◽

Kirschner Wire ◽

Distal Radius Fractures ◽

Radius Fractures ◽

Distal Radial Fractures ◽

Percutaneous Approach ◽

Intramedullary Stabilization ◽

Ulna Fractures ◽

Neck Fracture ◽

Reproducible Method

Background: Distal ulna fractures at the ulnar neck can be seen in association with distal radius fractures, and multiple techniques have been described to address the ulnar neck component of these injuries. We have found that treatment of ulnar neck fractures can be challenging in terms of anatomy and fracture fixation. We present a new percutaneous fixation technique for ulnar neck fractures commonly seen with distal radius fractures. Technique: Fixation of the ulnar neck fracture is performed after fixation of the distal radius fracture. Our technique uses anterograde intramedullary fixation to stabilize the fracture with a 1.6-mm (0.062 inch) Kirschner wire or a commercially available metacarpal fixation intramedullary nail. The fixation is introduced into the intramedullary space of the ulnar shaft 4 to 6 cm proximal to the fracture at a separate surgical site along the subcutaneous border of the ulna. The fixation is also supported with a sugar-tong splint for the first few weeks after surgery and requires removal of the ulnar implant approximately 10 weeks after implantation. Conclusion: Our technique utilizes a percutaneous approach with minimal fracture exposure. It provides a relatively simple and reproducible method to address ulnar neck fractures commonly seen in association with distal radial fractures.

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Conservative treatment of distal ulna metaphyseal fractures associated with distal radius fractures in elderly people

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2018.07.020 ◽

2018 ◽

Vol 104 (7) ◽

pp. 1101-1105 ◽

Cited By ~ 2

Author(s):

Kotaro Sato ◽

Kenya Murakami ◽

Yoshikuni Mimata ◽

Norio Numata ◽

Hideo Shiraishi ◽

...

Keyword(s):

Conservative Treatment ◽

Elderly People ◽

Distal Radius ◽

Distal Radius Fractures ◽

Radius Fractures ◽

Distal Ulna ◽

Metaphyseal Fractures

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Management of Distal Ulnar Fracture Combined with Distal Radius Fracture

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835516400075 ◽

2016 ◽

Vol 21 (02) ◽

pp. 155-160 ◽

Cited By ~ 5

Author(s):

Jae Kwang Kim ◽

Jong-Oh Kim ◽

Yong-Do Koh

Keyword(s):

Distal Radius Fracture ◽

Distal Radius ◽

Distal Radius Fractures ◽

Radius Fracture ◽

Surgical Approaches ◽

Radius Fractures ◽

Ulnar Styloid ◽

Cast Immobilization ◽

Distal Ulna ◽

Ulnar Styloid Fracture

The distal ulna is composed of the ulnar styloid, ulnar head, and distal ulnar metaphyseal area. Most of distal ulnar metaphyseal fractures are associated with distal radius fractures and this incidence tends to be greater in osteoporotic elderly. Consideration of the treatment of distal ulna metaphyseal fracture should be addressed after treating a distal radius fracture. If it is stable, cast immobilization is preferred, however, if it shows malalignment or instability, an operative method should be considered. More than half of distal radius fractures are combined with an ulnar styloid fracture, and considerable cases of ulnar styloid fractures result in nonunion. However, ulnar styloid nonunion usually does not cause any problems on the wrist. Recent studies of distal radius fractures treated using a volar locking plate have reported that neither the initial displacement nor the size of a concomitant ulnar styloid fracture affects clinical outcome, which suggests surgical approaches may usually not be indicated for ulnar styloid fractures.

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Treatment Modality of Distal Ulnar Head and Neck Fractures Associated With Operatively Treated Distal Radius Fractures Does Not Affect Outcomes

Hand ◽

10.1177/1558944720922923 ◽

2020 ◽

pp. 155894472092292

Author(s):

Georgina Glogovac ◽

Allison K. Perry ◽

Michael D. Wigton ◽

Peter J. Stern

Keyword(s):

Head And Neck ◽

Distal Radius ◽

Nonoperative Treatment ◽

Distal Radius Fractures ◽

Complication Rates ◽

Radius Fractures ◽

Distal Ulna ◽

Ulnar Head ◽

Patient Reported

Background: This study compares the functional outcomes and complications between operatively and nonoperatively treated distal ulnar head and neck fractures associated with internal fixation of concomitant distal radius fractures. Methods: A 7-year retrospective chart review was performed to identify patients with operatively treated distal radius fractures associated with distal ulnar head and neck fractures. Ulnar styloid fractures were excluded. Fifty-eight patients who had a minimum of 6 months of follow-up were identified. Patients were divided into 3 treatment groups: nonoperative, open reduction internal fixation (ORIF), and distal ulna resection. Reviewed data included demographics, injury and treatment details, complications, and patient-reported outcome measures. Outcomes measures included Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity and Patient-Rated Wrist Evaluation (PRWE) surveys. Due to inadequate power, 5 patients treated with distal ulna resection were excluded from statistical analysis. Results: The average patient age was 56 years, with an average follow-up of 27 months. All patients underwent ORIF of the distal radius fracture. Distal ulna fractures were treated nonoperatively in 25 patients, with ORIF in 28 patients, and with distal ulna resection in 5 patients. There were no statistically significant differences in wrist or forearm range of motion, complication rates, secondary procedure rates, PRWE scores, or PROMIS scores between ORIF and nonoperative treatment. Conclusion: No differences in wrist or forearm range of motion, complication rates, secondary procedure rates, PRWE scores, or PROMIS scores were observed between ORIF and nonoperative treatment of distal ulnar head and neck fractures associated with operatively treated distal radius fractures.

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