In isolation, distal ulna fractures are rare. They are often found in conjunction
with distal radius fractures, and the complexity of the interaction of the distal
ulna with the radioulnar joint and triangular fibrocartilage complex makes understanding
and treatment of distal ulna fractures challenging. Fixation of distal ulna fractures
can be problematic owing to comminution making reduction challenging. A thin soft
tissue can lead to hardware prominence and necessitate implant removal. In this Current
Concepts article, we review the anatomy, pathology, and treatment of distal ulna fractures
as well as potential complications and salvage procedures.
Key words
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References
- The distal radioulnar joint in relation to the whole forearm.Clin Orthop Relat Res. 1992; 275: 56-64
- Anatomical study of the distal end of cadaveric human ulnae: a clinical consideration for the management of distal radioulnar joint injuries.Singapore Med J. 2011; 52: 673-676
- The importance of the pronated grip x-ray view in evaluating ulnar variance.J Hand Surg Am. 2000; 25: 352-357
- Biomechanics of the distal radioulnar joint.Clin Orthop Relat Res. 1984; 187: 26-35
- The value of plain x-rays in predicting TFCC injury after distal radial fractures.J Hand Surg Eur Vol. 2008; 33: 322-326
- Diagnostic accuracy of magnetic resonance imaging and magnetic resonance arthrography for triangular fibrocartilaginous complex injury: a systematic review and meta-analysis.J Bone Joint Surg Am. 2012; 94: 824-832
- The Comprehensive Classification of Fractures of Long Bones.Springer, Berlin1990: 106-115
- Fractures of the distal radius and ulna.J Hand Surg Br. 1995; 20: 357-364
- Clinical impact of united versus nonunited fractures of the proximal half of the ulnar styloid following volar plate fixation of the distal radius.J Hand Surg Am. 2010; 35: 223-227
- Should an ulnar styloid fracture be fixed following volar plate fixation of a distal radial fracture?.J Bone Joint Surg Am. 2010; 92: 1-6
- The effect of an associated ulnar styloid fracture on the outcome after fixation of a fracture of the distal radius.J Bone Joint Surg Br. 2009; 91: 102-107
- Ulnar styloid fracture with distal radius fracture.J Hand Surg Am. 2012; 37: 568-569
- Triangular fibrocartilage complex tears associated with symptomatic ulnar styloid nonunions.J Hand Surg Am. 2010; 35: 1251-1255
- Treatment of ulnar shaft fractures: a prospective, randomized study.Orthopedics. 1995; 18: 543-547
- Isolated ulnar shaft fractures. Comparison of treatment by a functional brace and long-arm cast.J Bone Joint Surg Br. 1992; 74: 757-759
- Interventions for isolated diaphyseal fractures of the ulna in adults.Cochrane Database Syst Rev. 2004; 2: CD000523
- Intra-articular distal ulnar fractures associated with distal radial fractures in older adults: early experience in fixation of the radius and leaving the ulna unfixed.J Hand Surg Eur Vol. 2009; 34: 592-597
- The cutaneous innervation of the dorsal hand: detailed anatomy with clinical implications.J Hand Surg Am. 2006; 31: 565-574
- The treatment of isolated fractures of the distal ulna.J Bone Joint Surg Br. 1984; 66: 408-410
- Open reduction and internal locked fixation of unstable distal ulna fractures with concomitant distal radius fracture.J Hand Surg Am. 2007; 32: 801-805
- Condylar blade plate fixation of unstable fractures of the distal ulna associated with fracture of the distal radius.J Hand Surg Am. 2004; 29: 103-109
- Outcome following acute primary distal ulna resection for comminuted distal ulna fractures at the time of operative fixation of unstable fractures of the distal radius.Hand (N Y). 2009; 4: 391-396
- Initial shortening and internal fixation in combination with a Sauvé-Kapandji procedure for severely comminuted fractures of the distal radius in elderly patients.J Bone Joint Surg Br. 2010; 92: 1558-1562
- Salvage of failed resection arthroplasties of the distal radioulnar joint using an ulnar head prosthesis: long-term results.J Hand Surg Am. 2012; 37: 1372-1380
- Reconstruction of a posttrauma arthritic distal radioulnar joint by vascularized second metatarsophalangeal joint transfer.Plast Reconstr Surg. 2006; 117: 19e-23e
- Reconstruction of the ulnar head with a vascularized second metatarsal head: case report.J Hand Surg Am. 2012; 37: 1568-1573
- Open reduction and internal locked fixation of unstable distal ulna fractures with concomitant distal radius fracture.J Hand Surg Am. 2007; 32: 801-805
- 3rd. Compression-plate fixation in acute diaphyseal fractures of the radius and ulna.J Bone Joint Surg Am. 1975; 57: 287-297
- Conservative management of minimally displaced isolated fractures of the ulnar shaft.Acta Orthop Belg. 2007; 73: 710-713
- Treatment of non-union of forearm bones with a free vascularised corticoperiosteal flap from the medial femoral condyle.Acta Orthop Belg. 2009; 75: 611-615
- The vascularized medial femoral condyle periosteal bone flap for the treatment of recalcitrant bony nonunions.Ann Plast Surg. 2008; 60: 174-180
- Posterior interosseous artery distal radius graft for ulnar nonunion treatment.J Hand Surg Am. 2012; 37: 2605-2610
- Double plate fixation for correction of the malunited distal ulna fracture: a case report.Hand Surg. 2011; 16: 335-337
Article info
Publication history
Published online: January 10, 2014
Accepted:
August 10,
2013
Received:
February 10,
2013
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
