Purpose
To evaluate the results following locking plate fixation of unstable distal ulna fractures
with concomitant distal radius fracture.
Methods
A retrospective review was conducted to identify patients who had been treated with
a locking plate for unstable displaced fractures of the distal ulna in which a concomitant
ipsilateral distal radius fracture was also treated operatively. Medical records and
radiographs were reviewed, and 5 patients were identified with an average age of 52
years (range, 47–61 years) and with follow-up averaging 11.6 months (range, 6–17 months).
There were 2 open and 3 closed fractures. Included was 1 simple neck, 1 comminuted
neck, 1 head, and 2 head and neck fractures of the distal ulna. All distal radius
fracture implants were locked volar plates.
Results
All distal ulna and distal radius fractures united, and the average motion was: flexion
59°; extension 59°; pronation 67°; and supination 72°. Average grip strength was 97%
of the opposite extremity. Final ulnar variance averaged −0.4 mm (ulnar negative),
radial inclination was 20°, and volar tilt was 8°. All distal radioulnar joints were
stable. Two patients had mild, transient paresthesias of the dorsal sensory branch
of the ulnar nerve, and both patients recovered completely within 3 months. There
were no subsequent surgeries or hardware failures. There were no infections and no
wound problems. Based upon the Sarmiento modification of the Gartland and Werley rating
score, there were 4 excellent results and 1 good result.
Conclusions
Locked plating of unstable distal ulna fractures, in the setting of an associated
distal radius fracture, resulted in union, good to excellent alignment and motion,
nearly symmetric grip strength, and minimal transient morbidity.
Type of study/level of evidence
Therapeutic IV.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Fractures of the distal radius and ulna.J Hand Surg. 1995; 20A: 357-364
- Surgical management of delayed union and nonunion of distal radius fractures.J Hand Surg. 2001; 26A: 201-209
- Nonunion of distal radial fractures associated with distal ulnar shaft fractures: a report of four cases.J Orthop Trauma. 1997; 11: 49-53
- Nonunion of the distal radius.Hand Clin. 2005; 21: 443-447
- Volar fixation for dorsally displaced fractures of the distal radius: a preliminary report.J Hand Surg. 2002; 27A: 202-215
- Volar fixed-angle plate fixation for unstable distal radius fractures in the elderly patient.J Hand Surg. 2004; 29A: 96-102
- Fracture of the distal radius including sequelae-shoulder-hand-finger syndrome, disturbance in the distal radio-ulnar joint and impairment of nerve function.Acta Orthop Scand Suppl. 1967; 108: 1-155
- Distal radioulnar joint injuries associated with fractures of the distal radius.Clin Orthop. 1996; 327: 135-146
- Ulnar styloid fractures associated with distal radius fractures: incidence and implications for distal radioulnar joint instability.J Hand Surg. 2002; 27A: 965-971
- Condylar blade plate fixation of unstable fractures of the distal ulna associated with fracture of the distal radius.J Hand Surg. 2004; 29A: 103-109
- The effects of angular and rotational deformities of both bones of the forearm.J Bone Joint Surg. 1984; 66A: 65-70
- Mechanism of limitation of pronation/supination of the forearm in geometric models of deformities of the forearm bones.Biomechanics. 2002; 17: 456-463
- Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses.J Bone Joint Surg. 1976; 58A: 453-458
- Problems in the management of type III (severe) open fractures: a new classification of type III open fractures.J Trauma. 1984; 24: 742-746
- The comprehensive classification of fractures of long bones. Springer-Verlag, Berlin1990: 106-115
- Functional and radiographic anatomy.in: Fernandez D.L. Jupiter J.B. Fractures of the distal radius A practical approach to management. Springer-Verlag, New York1995: 53-66
- Colles’ fractures: functional bracing in supination.J Bone Joint Surg. 1975; 57A: 311-317
- Evaluation of healed Colles’ fractures.J Bone Joint Surg. 1951; 33A: 895-907
- Stability assessment of distal radius fractures.Injury. 1989; 20: 208-210
- Predicting the outcome of distal radius fractures.Hand Clin. 2005; 21: 289-294
Article info
Publication history
Accepted:
March 16,
2007
Received:
December 4,
2006
Footnotes
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Identification
Copyright
© 2007 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
