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BACKGROUND: To describe the surgical technique of non-compressive intramedullary threaded nail (IMTN) fixation of distal ulnar neck fractures and present the clinical and radiographic outcomes of four patients treated with this novel technique. METHODS: At a single Level 1 Trauma Center, a retrospective review was conducted for patients with distal ulnar neck fractures treated with retrograde IMTN between 2022 and 2024. Exclusion criteria included inadequate follow-up. A single surgeon performed all procedures using percutaneous retrograde IMTN fixation through the central disc of the triangular fibrocartilage complex (TFCC). Patients initiated a range of motion (ROM) protocol two weeks post-operatively. Post-operative radiographic images were used to calculate the ratio of IMTN diameter to the distal ulnar medullary isthmus diameter proximal to the fracture site. Radiographic changes in displacement, angulation, and ulnar variance were calculated between the first and last follow-up radiographs. Functional outcomes including grip strength and ROM were collected. RESULTS: Four patients with distal ulnar neck fractures were treated with retrograde IMTN between 2022 and 2024. They were followed for a minimum of three months post-operatively. All were female with an average age of 65 years. All distal ulna fractures were associated with operatively treated intraarticular distal radius fractures. All patients were treated with 75 mm length and 4.5 mm diameter IMTNs. IMTN-to-Isthmus ratio was greater than 60% in all cases. Average radiographic displacement and angulation were unchanged at the final follow-up. The average ulnar variance increased by 1.2 mm. At the final follow-up, there were no post-operative complications. No cases demonstrated ulnar-sided wrist pain, nonunion, or required revision surgery. CONCLUSIONS: Retrograde IMTN fixation is a novel surgical technique for the treatment of distal ulnar neck fractures. We found limited but promising post-operative radiographic and functional outcomes in our patients without reported ulnar-sided wrist pain, nonunion, or need for hardware removal.
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Introduction: Giant cell tumors (GCT) are a relatively uncommon type of non-cancerous bone growth, representing around 4-10% of all bone tumors. These tumors tend to exhibit local aggressiveness and are typically prevalent in individuals between 20 and 40 years old. Commonly observed locations for GCT include the distal femur, proximal tibia, and the distal end of the radius. However, occurrences at the distal end of the ulna are rare, accounting for only 0.45-3.2% of cases. Case Report: In this instance, we present the case of a 36-year-old male diagnosed with a GCT specifically located in the left distal ulna. Our approach involved managing the patient through the complete removal (en-bloc resection) of the distal ulna. Following this, we performed an extensor carpi ulnaris (ECU) tenodesis to stabilize the proximal stump. After 2-year follow-up, the patient exhibited positive outcomes, displaying satisfactory wrist joint mobility and functionality without any signs of tumor recurrence. Conclusion: This case emphasizes the effectiveness of wide resection as a viable treatment for huge GCTs in the distal ulna. Utilizing tenodesis with the tendon of ECU significantly contributes to stabilizing the ulnar stump, leading to improved wrist function.
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Background The volar dislocation of the distal ulna is an uncommon injury and often missed due to its rarity. If diagnosed early, it can be managed with a simple closed reduction followed by immobilization. Open reduction is recommended in case of any interposition preventing reduction. Case Description In this case report, we present a rare case of neglected volar distal ulna dislocation associated with a distal radius fracture presenting with a fixed supination deformity that was managed successfully with a Sauvé- Kapandji procedure using a modified approach to restore forearm rotation. At 10 months, the patient had a good union at the distal radio ulnar joint (DRUJ) with improved forearm rotations. Literature Review To our knowledge no previous cases of neglected volar distal ulna dislocation with distal radius fracture has been reported in the literature. Clinical Relevance If DRUJ stability cannot be restored after closed reduction of distal radius fracture, open reduction and internal fixation of the fracture should always be performed to avoid subsequent DRUJ subluxation/dislocations.
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Purpose Reconstruction and stabilization of ulnar stump after distal ulna tumor resection is still a matter of debate. We present the outcomes of ulnar buttress arthroplasty without stabilization of the ulna stump in giant cell tumor of bone (GCTB) of the distal ulna. Methods Evaluation of functional outcome was performed using Musculoskeletal Tumor Society 93 (MSTS93) score, Modified Mayo Wrist score (MMWS), and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. We also assessed the hand grip strength, range of motion at the wrist, and ulnar carpal translation. Results The study included 8 patients with Campanacci grade 3 GCTB of the distal ulna with a mean follow-up of 35.5 ± 9.1 months. The mean resection length was 7.7 ± 1.3 cm. The mean hand grip strength on the operated side was noted to be 90 ± 0.04% of the contralateral side. Mean MSTS93 score was 27.9 ± 1.25, mean MMWS was 86.9 ± 4.58%, and the mean DASH score was 4.9 ± 1.67, depicting a good to excellent functional outcome with low degree of disability. No radiocarpal instability, ulnar carpal translation, prominence, or instability of the proximal ulnar stump was noted in any patient. Conclusion Reconstruction of the distal radioulnar joint using iliac crest bone graft for ulnar buttress without stabilization of the ulnar stump after resection of the distal ulna is an effective reconstruction option with good functional outcome and preservation of good hand grip strength. Level of Evidence Level IV, Therapeutic study.
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Introduction: Giant Cell Tumours (GCT) are benign tumours with aggressive potential that disrupt the local bony architecture, which can be especially problematic in peri-articular locations. Our aim was to assess the outcomes of patients with GCT of the distal ulna who were treated by resection without reconstruction. Methods: The study included 21 patients with distal ulna GCT that were treated with resection without reconstruction. There were 12 males and 9 females, with a mean age of 30.4years (range 14-45 years). The patients mean follow-up period was 4.4 years, with a two-year minimum follow-up. Results: Painful swelling was the presenting symtom in all cases. Nineteen patients had Campanacci grade 3 and two had Campanacci grade 2. The mean resected length of the distal ulna was 6.8 cm (range 4-10) cm. The Musculoskeletal Tumor Society score (MSTS) was 26.1. (range 22-28). Grip strength of the affected hand was reduced by 10.5% on average. (range 0%-16%). Two patients were having multi-centric disease on presentation and none of the cases had pathological fracture on presentation. One case had a local recurrence which was treated with surgery. Conclusion: Based on current study, GCT of the distal ulna, en bloc resection without reconstruction can be recommended as a valuable treatment option for Campanacci grades 2 and 3 tumours. Resection of the distal end of the ulna without reconstruction results in excellent functional outcomes, with forearm rotational movement and hand function preserved. According to review of literature this is the largest series of GCT Ulna and we recommend a multicentre and comparitive studies on this topic.
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We conducted an ambispective cohort study to assess the association between symptomatic radioulnar impingement syndrome (SRUIS) and distal radioulnar joint (DRUJ) salvage surgery to examine the influence of confounders on the final effect. The outcome variable was the incidence of SRUIS and the exposure variable was the surgical procedure. Seventy-two patients with median age of 48 years (IQR 25-78) were examined using bivariate and logistic regression multivariate analyses, and confounders were analysed in 15 multivariate models. Overall, SRUIS occurred in 21 patients (29%). Bivariate analysis showed a significant association between SRUIS and type of surgical procedure, observed in 71% after Sauvé-Kapandji, 50% after Bowers and 15% after Darrach procedure. When adjusted for age, aetiology and previous surgery, the significant association disappeared. Confounding is an important factor when accounting for SRUIS after DRUJ salvage surgery. The risk of SRUIS did not depend on the procedure, but rather on patient's age, aetiology and previous surgery.Level of evidence: II.
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Osteoartrite , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Osteoartrite/cirurgia , Ulna/cirurgia , Estudos de Coortes , Fatores de Confusão Epidemiológicos , Articulação do Punho/cirurgiaRESUMO
Ulnar styloid fractures commonly occur in the setting of distal radius fractures and often progress to asymptomatic nonunion. Displaced basilar ulnar styloid fractures involving the deep radioulnar ligament attachments may cause distal radioulnar joint (DRUJ) instability. A careful clinical history, physical examination, review of imaging studies, and selected diagnostic interventions are important for confirming the relationship of the ulnar styloid nonunion with ulnar-sided wrist symptoms and/or DRUJ instability. Improved functional and symptomatic outcomes can be achieved with nonunion repair or fragment excision with or without triangular fibrocartilage complex repair, depending on the location and size of the ulnar styloid fracture.
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Instabilidade Articular , Fraturas do Rádio , Fibrocartilagem Triangular , Fraturas da Ulna , Humanos , Articulação do Punho/cirurgia , Resultado do Tratamento , Fraturas do Rádio/cirurgia , Fixação Interna de Fraturas/métodos , Fibrocartilagem Triangular/cirurgia , Fraturas da Ulna/cirurgia , Instabilidade Articular/diagnósticoRESUMO
OBJECTIVES: Distal ulna plate fixation for ulnar neck and head fractures (excluding ulnar styloid fractures) aims to anatomically reduce the distal ulna fracture (DUF) by open reduction and internal fixation, while obtaining a stable construct allowing functional rehabilitation without need for cast immobilization. INDICATIONS: Severe displacement, angulation or translation, as well as unstable or intra-articular fractures. Furthermore, multiple trauma or young patients in need of quick functional rehabilitation. CONTRAINDICATIONS: Inability to surgically address concomitant ipsilateral extremity fractures, thus, limiting early active rehabilitation. Stable, nondisplaced fractures. Need for bridging plate or external fixator of distal radiocarpal joint. SURGICAL TECHNIQUE: An ulnar approach, with a straight incision between the extensor and flexor carpi ulnaris. Preservation of the dorsal branch of the ulnar nerve. Reduction and plate fixation with avoidance of plate impingement in the articular zone. POSTOPERATIVE MANAGEMENT: Postoperatively, an elastic bandage is applied for the first 24-48â¯h. In isolated DUF with stable fixation, a postoperative splint is often unnecessary and should be avoided. For the first four weeks, only light weightbearing of everyday activities is allowed to protect the osteosynthesis. Thereafter, heavier weightbearing and activities are allowed and can be increased as tolerated. RESULTS: The best available evidence likely shows that for younger patients with a DUF, with or without concomitant distal radius fractures, open reduction and internal fixation can be safely achieved with good functional outcome and acceptable union and complication rates as long as proper technique is ensured.
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Fraturas do Rádio , Fraturas da Ulna , Fraturas do Punho , Humanos , Resultado do Tratamento , Fraturas do Rádio/cirurgia , Fraturas da Ulna/diagnóstico por imagem , Fraturas da Ulna/cirurgia , Articulação do Punho/cirurgia , Fixação Interna de Fraturas/métodos , Placas Ósseas , UlnaRESUMO
Background Isolated distal ulna fractures are rare injuries and are commonly associated with distal radius fractures. Though most of them can be managed conservatively, few of them require open reduction due to the interposition of various structures. Case Description In this case report, we report two cases of irreducible isolated distal ulna fractures in adolescents due to the interposition of the extensor retinaculum with its underlying tendons requiring open reduction to achieve bony union and distal radioulnar joint stability. These distal ulna fractures can be best reduced by open reduction with hypersupination and maintaining the distal ulna shaft gothic arch with pins. Literature Review There are very few case reports reported on isolated distal ulna fractures commonly seen in paediatric and adolescent patients leading to growth arrest. The interposition of various structures is a cause of irreducibility requiring open reduction. These fractures are equivalent to TFCC injuries in adults. Clinical Relevance Whenever there is a gross displacement or difficult reduction interposition is to be considered. Open reduction of the fracture and maintenance of DRUJ congruity is sufficient without being critical on articular reduction.
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Attritional extensor tendon ruptures are common in the setting of arthritis but, to our knowledge, have never previously been reported in the setting of a distal ulna fracture. This case report describes a 56-year-old male patient who sustained a left-hand dog bite resulting in crush injuries to the thumb and ring finger and a minimally displaced distal ulna fracture. The patient initially underwent appropriate surgical intervention for the thumb and finger crush injuries and non-operative management of the distal ulna fracture with splint immobilization. He experienced an extensor digiti minimi tendon (EDM) rupture two and a half weeks post-operatively. Radiographs demonstrated interval distal ulna fracture displacement with a prominent dorsal spike and absence of arthritis. He subsequently underwent distal ulna open reduction internal fixation and an extensor indicis proprius (EIP) to EDM tendon transfer. This case demonstrates a novel complication following non-operative management of a distal ulna fracture in which the prominent dorsal distal ulna resulted in direct irritation to the extensor tendon and subsequent attritional extensor tendon rupture. This potential complication should be considered in determining appropriate treatment for distal ulna fractures.
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OBJECTIVE: The wrist is the second most commonly involved location for GCTB, while distal ulna is a relatively rare location and limited evidence exists on which surgical approaches and reconstruction techniques are optimal. We carried out a multicenter retrospective study to evaluate the recurrence rate of distal ulna GCTB and the long-term functional outcomes of different surgery options. METHODS: All 28 patients received surgical treatment for distal ulna GCTB in one of three tertiary bone tumor centers between May 2007 and January 2021 with a minimum two-year follow-up. Surgical options included intralesional curettage or en bloc resection (one of 3 types). Functional outcomes were assessed by the MSTS score, the QuickDASH instrument, MWS, and MHQ according to the latest treatment. RESULTS: Overall recurrence rate was 14.2%. The curettage group (N = 7) had a significantly higher recurrence rate compared to en bloc resection (N = 21) (42.9% vs 4.8%) (mean follow-up: 88.8 mo). Seven patients received the Darrach procedure, 5 received the original Sauvé-Kapandji procedure, and 9 received the modified Sauvé-Kapandji procedure with extensor carpi ulnaris (ECU) tenodesis. Of the 4 patients having a recurrence, 1 received the Darrach EBR, 2 received the modified Sauvé-Kapandji procedure, and 1 received resection for soft tissue recurrence. Only MWS and esthetics in the MHQ scores were different (curettage, Darrach, Sauvé-Kapandji, and Sauvé-Kapandji with ECU tenodesis [MWS: 96.5 ± 1.3 vs 91.5 ± 4.7 vs 90.8 ± 2.8 vs 91.5 ± 3.6; esthetics in MHQ: 98.5 ± 3.1 vs 89.9 ± 4.7 vs 93.8 ± 4.4 vs 92.6 ± 3.8], respectively). CONCLUSIONS: En bloc resection for distal ulna GCTB had a significantly lower recurrence rate compared with curettage and achieved favorable functional outcome scores. Given the higher recurrence rate after curettage, patients should be well informed of the potential benefits and risks of selecting the distal radioulnar joint-preserving procedure. Moreover, reconstructions after tumor resection of the ulna head do not appear to be necessary.
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Neoplasias Ósseas , Tumor de Células Gigantes do Osso , Humanos , Punho , Estudos Retrospectivos , Ulna/cirurgia , Articulação do Punho/cirurgia , Tumor de Células Gigantes do Osso/patologia , Curetagem , Neoplasias Ósseas/patologiaRESUMO
Giant cell tumors (GCTs) are rare, benign, and locally invasive tumors, typically found in the epiphysis of long bones, most commonly at the distal femur and proximal tibia. To date, GCTs of the distal end of the ulna have been very rare. We document a case of a 38-year-old female with a distal ulna GCT, managed with en-bloc resection of the tumor with flexor carpi ulnaris and extensor carpi ulnaris tendon stabilization. The main aim of the GCT treatment is to prevent local recurrence and to maintain the function of the limb. Physical therapy was also given to the patient which helped in relieving pain, reducing edema, and increasing strength and range of motion. The patient was able to perform activities of daily living with the help of physical therapies and exercises. More research is needed to determine if broad excision of the distal ulna alone is a successful therapy for primary bone cancers affecting the distal ulna, including GCTs.
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Purpose: Distal ulna fractures can often be treated nonsurgically; however, many surgeons consider significant displacement or instability, especially following fixation of an associated distal radius fracture, an indication for surgical fixation because of potential problems associated with malunion of these fractures. Traditionally, these fractures have been addressed with plate fixation but hardware in this location is often prominent and associated with a high rate of symptomatic hardware and subsequent hardware removal. We proposed a method of intramedullary fixation using a specialized threaded pin. As this fixation is intramedullary, it avoids many of the problems associated with traditional surgical treatment methods for this fracture. We present a series of nine patients treated in this manner, all of whom had associated distal radius fractures. Methods: Preoperative and postoperative radiographs were reviewed, after which patients were contacted via phone. Patient-reported outcome measures, including QuickDASH and visual analog scale scores, were assessed. Results: The average QuickDASH score was 13.6 (range, 0-100), with a median of 9.1. Three patients reported occasional ulnar-sided wrist pain, with an average visual analog scale score of 1.3 (range, 0-10) and a median of 0.5. All patients returned to all activities except one patient who could not resume playing musical instruments because of stiffness. No patient required removal of the threaded pin, but one patient underwent removal of the radial volar plate. No other patients underwent secondary procedures. Conclusions: Threaded pin fixation is a viable alternative to existing options for distal ulnar neck fractures and may have an advantage over plate fixation because of a lack of hardware prominence. Type of study/level of evidence: Therapeutic IV.
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Purpose: This study sought to conduct several three-dimensional measurements of the distal ulna in healthy Han Chinese, providing the anatomical basis for the diagnosis and treatment of hand trauma, distal ulnar disorders, and the design of wrist prostheses. Methods: 50 Han Chinese men and women that underwent computed tomography (CT) scans of the distal ulnar carpus were included in the present study. A three-dimensional digital model of the distal ulna was reconstructed using Mimics software. Moreover, the anatomical data of 10 indicators were measured using MIMICS software. Each index data was measured by 2 investigators independently, and the average value was taken. The data were stratified and compared between left and right sides and men and women. Results: A 3D digital model of the distal ulnar bone with a realistic shape was reconstructed. The 10 anatomical parameters measured are as follows: The length of the ulnar styloid process (posterior anterior), The length of the ulnar styloid process(anterior and posterior); the transverse diameter of the ulnar head; the anteroposterior diameter of the ulnar head. The radial inclination angle of the ulna; the ulnar inclination angle; the distal space between the ulna and radius; the ulnar notch angle of the lower radius. The anterior and posterior diameters of the ulnar notch of the lower radius, and the superior and inferior diameters of the ulnar notch of the lower radius. Statistical analysis showed no significant difference after stratification by laterality and gender. Conclusion: our findings can providing the anatomical basis for the diagnosis and treatment of hand trauma, distal ulnar disorders and further improve currently available wrist joint prostheses. Type of Study: Observational, Cross-sectional study, LOE: Level II.
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We conducted a retrospective multicentre study to compare the clinical and radiographic outcomes, and complications of three surgical treatments of distal ulna fracture (DUF) when combined with anterior locking plate fixation for distal radial fracture (DRF) in patients over 70 years of age. We identified 1521 patients over 70 years of age who were diagnosed as having DRF and who underwent anterior locking plate fixation between 2015 and 2020, among which 122 cases of DUF were analysed. Three surgical treatment options for DUF were identified in this cohort: K-wire fixation (Group K), locking plate fixation (Group L) and Darrach procedure (Group D). The results of the analysis showed the total immobilization period in Group D to be the shortest among the three treatments. Functional outcomes were superior, and the rate of complications were smaller in Group D than in Group L. In addition, rotational range of motion was larger in Group D and Group L compared with Group K. In patients who are 70 years of age or older with combined unstable DRF and highly comminuted or displaced DUF, the Darrach procedure for DUF seems to be the most useful and reasonable treatment option once the fracture of the distal radius has been rigidly fixed.Level of evidence: IV.
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Fraturas do Rádio , Fraturas do Punho , Humanos , Idoso , Idoso de 80 Anos ou mais , Rádio (Anatomia) , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/cirurgia , Resultado do Tratamento , Fixação Interna de Fraturas/métodos , Placas Ósseas , Amplitude de Movimento ArticularRESUMO
INTRODUCTION: Given the absence of a satisfying plate system to deal with multifragmentary or subcapital distal ulnar fractures, the Distal Ulna Locking Plate (DUL, I.T.S. GmbH, Graz, Austria) could become a useful treatment option. This study aimed to evaluate the results of this anatomically pre-contoured plate regarding patients with unstable or displaced distal ulnar fractures. METHODS: In a prospective clinical trial, 20 patients (18 female, two male; mean age 70 years (24-91 years)) with unstable or displaced distal ulna fractures between December 2010 and August 2015 were analyzed. All patients were treated with open reduction and internal fixation using the DUL. They were evaluated at three follow-up appointments at 3, 6 and 12 months postoperatively regarding their bone healing, ulnar variance (UV), range of motion (ROM) and grip strength. Patient related outcomes were measured using the Disability of the Arm, Shoulder and Hand (DASH), the Patient Rated Wrist Evaluation (PRWE) questionnaires, and the Visual Analogue Scale (VAS). The results after one year were compared to the outcome of the healthy contralateral side. RESULTS: All fractures treated with open reduction and internal fixation using the Distal Ulna Locking Plate healed within 6 months and showed stable ulnar variances after surgery. ROM (rotational plane 81.1 ± 9.0°, sagittal plane 55.1 ± 14.6°, frontal plane 33.0 ± 9.4°) and grip strength (18.7 ± 7.1 N) at the follow-up after 12 month had similar values compared with the uninjured side. The mean DASH score (36.4 ± 29.0), the PRWE-score (14.5 ± 27.0), and the VAS (at rest 0.5 ± 1.1, during activity 1.2 ± 2.4) after one year had no significant difference to the uninjured side. The surgeon's overall satisfaction rate regarding plate handling reached 81.8%. CONCLUSION: Stabilization of unstable distal ulna fractures using the DUL restores nearly normal anatomy and function. Its pre-countered design, volar placement, and enhanced stability present a satisfying plate system. TRIAL REGISTRATION: The trial was retrospectively Registered at www. CLINICALTRIALS: gov on 16 December 2021 (Trial Registration Number: NCT05329012).
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Fraturas do Rádio , Fraturas da Ulna , Fraturas do Punho , Humanos , Masculino , Feminino , Idoso , Punho , Fraturas do Rádio/cirurgia , Ulna/cirurgia , Fixação Interna de Fraturas/métodos , Fraturas da Ulna/cirurgia , Placas Ósseas , Resultado do Tratamento , Amplitude de Movimento ArticularRESUMO
INTRODUCTION: Isolated volar dislocations of the distal radioulnar joint are reported as rare. We observed three such cases over a 12-month period. Literature to date consists of multiple case reports and case series with no structured reviews. There is debate as to incidence, mechanism, investigation, treatment and prognosis. METHODS: A case series and formal systematic review was performed. This included an analysis of the demographics, mechanism, presentation, investigation, treatment and outcome of the cases identified from the wider published series. FINDINGS: In total 99 cases of this injury were identified from 59 papers, with a further 9 cases having an associated ulna styloid fracture. CONCLUSIONS: This is a rare injury, representing up to 0.02% of all bony injuries, which is diagnosed late in 36% of cases. Inability to obtain a true lateral radiograph may contribute to the diagnosis being missed. Computed tomography scans are useful in suspected cases without radiographic confirmation. Acute cases are successfully treated with closed reduction in 78% of cases; however associated soft tissue injuries may need to be surgically addressed. Delayed presentation is more likely to require open surgery and preoperative MRI scans are indicated to aid surgical planning. Chronic instability rarely occurs and may need treatment with reconstruction or salvage. A good, subjective, result is reported in the majority of patients.
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Luxações Articulares , Fraturas do Rádio , Fraturas da Ulna , Traumatismos do Punho , Humanos , Traumatismos do Punho/diagnóstico por imagem , Traumatismos do Punho/cirurgia , Luxações Articulares/diagnóstico por imagem , Luxações Articulares/cirurgia , Articulação do Punho/diagnóstico por imagem , Articulação do Punho/cirurgia , Fraturas da Ulna/diagnóstico por imagem , Fraturas da Ulna/cirurgia , Radiografia , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/cirurgiaRESUMO
INTRODUCTION: Fractures of the distal ulna, excluding the styloid, are rare. The cause of injury is often a fall on an outstretched hand with an extended wrist, and in most cases there is a concomitant distal radius fracture. The aims of this retrospective study were to investigate the results of the current treatment of distal ulna fractures in adults, with or without a concomitant distal radius fracture, and if a recently presented fracture classification could predict outcome. MATERIALS AND METHODS: Patients, 18 years or older, treated for a fracture of the distal third of ulna in our county, were included. Fractures of the styloid tip were excluded. The radiographs of the fractures were independently classified by two specialists in radiology according to the 2018 AO/OTA classification. Follow-up was performed 5-7 years after the injury, through the questionnaire Patient-Rated Wrist Evaluation (PRWE) and new radiographs of both wrists. RESULTS: Ninety-six patients with 97 fractures were included and filled out the PRWE. 65 patients also had new radiographs taken. 79 patients were women and the mean age at the time of injury was 63 years (SD 14.5). The most common fracture class was the extra-articular transverse fracture, 2U3A2.3 (42%). We found that 40% of the fractures had been treated by internal fixation and only 2 fractures had not healed, one conservatively treated and one operated. The median PRWE was 15 (IQR 33.5). The PRWE score was significantly worse in the operated ulna fractures (p = 0.01) and this was also true for extra-articular transverse fractures 2U3A2.3 (p = 0.001). Initial displacement was more common in operated transverse fractures, but it could not be proven that this was the reason for the inferior result. CONCLUSIONS: Distal ulna fractures almost always unite and the result is comparable to that of isolated distal radius fractures when measured by PRWE. Based on the opinions of the radiologists and how often a consensus discussion was needed for classification, we found the updated AO classification system difficult to use, if dependent only on standard radiographic views. In the present study, transverse extra-articular ulna fractures did not benefit from internal fixation regardless if associated with a distal radius fracture or isolated.
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Fraturas do Rádio , Fraturas da Ulna , Fraturas do Punho , Humanos , Adulto , Feminino , Pessoa de Meia-Idade , Masculino , Punho , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/cirurgia , Fraturas do Rádio/complicações , Estudos Retrospectivos , Ulna , Fraturas da Ulna/diagnóstico por imagem , Fraturas da Ulna/cirurgia , Fixação Interna de Fraturas/métodos , Resultado do Tratamento , Amplitude de Movimento Articular , Placas Ósseas/efeitos adversosRESUMO
An active, 62-year-old man presented with a nondisplaced pathological fracture through a low-grade, central chondrosarcoma of the distal ulnar diaphysis after minor trauma. After obtaining diagnostic imaging, the patient was successfully treated with marginal en-bloc resection of the right distal ulnar diaphysis and wrist reconstruction via a Sauve-Kapandji arthroplasty. Suave-Kapandji arthroplasty is an alternative reconstruction to complete the excision of the distal ulna following resection of the distal ulnar diaphysis.