Open Reduction and Internal Locked Fixation of Unstable Distal Ulna Fractures With Concomitant Distal Radius Fracture

David G. Dennison

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)801-805
Number of pages5
JournalJournal of Hand Surgery
Volume32
Issue number6
DOIs
StatePublished - Jul 2007

Fingerprint

Ulna Fractures
Radius Fractures
Neck
Hand Strength
Head
Closed Fractures
Pronation
Supination
Ulna
Ulnar Nerve
Paresthesia
Wound Infection
Medical Records
Extremities
Joints
Morbidity

Keywords

  • Distal radius fracture
  • distal ulna fracture
  • locked plating
  • open reduction

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Open Reduction and Internal Locked Fixation of Unstable Distal Ulna Fractures With Concomitant Distal Radius Fracture. / Dennison, David G.

In: Journal of Hand Surgery, Vol. 32, No. 6, 07.2007, p. 801-805.

Research output: Contribution to journalArticle

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abstract = "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.",
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AB - 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.

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