Abstract
Purpose
The advent of locking compression plate (LCP) has provided convenient and secure fixation of distal ulna fractures. This study was performed to evaluate the functional and clinical outcomes following LCP distal ulna plate fixation of irreducible or unstable distal ulna fractures with concomitant distal radius fractures.
Methods
Retrospective review of 17 patients who had been treated with LCP distal ulna plates for distal ulna fractures was performed. The average age of the patients was 58.9 years (range 21–87 years), and the mean follow-up period was 15 months (range 12–20 months). This study consisted of eleven fractures involving metaphysis and six ulna styloid base fractures. Fracture union, radiologic parameters, stability of the distal radioulnar joint (DRUJ), and functional outcomes, including ROM, grip strength, and functional scores were evaluated.
Results
All patients showed bony union, the average radial height was 10.5 mm, and the ulnar variance was 0.8 mm on final radiographs. None of the patients had instability of the DRUJ compared with the opposite wrist, and the subluxation ratio was within normal range on the follow-up CT scan. There were 6 excellent and 11 good cases according to Sarmiento’s modified wrist score at the last follow-up.
Conclusions
Locking compression plate distal ulna plate fixation of irreducible or unstable distal ulna fractures after stabilization of concomitant distal radius fractures showed favorable results in union, alignment, and functional outcomes and therefore could be one of the recommendable implant options for distal ulna fractures.
Similar content being viewed by others
References
Biyani A, Simison AJ, Klenerman L (1995) Fractures of the distal radius and ulna. J Hand Surg 20(3):357–364
Fernandez DL, Ring D, Jupiter JB (2001) Surgical management of delayed union and nonunion of distal radius fractures. J Hand Surg 26(2):201–209. doi:10.1053/jhsu.2001.22917
McKee MD, Waddell JP, Yoo D, Richards RR (1997) Nonunion of distal radial fractures associated with distal ulnar shaft fractures: a report of four cases. J Orthop Trauma 11(1):49–53
Dennison DG (2007) Open reduction and internal locked fixation of unstable distal ulna fractures with concomitant distal radius fracture. J Hand Surg 32(6):801–805. doi:10.1016/j.jhsa.2007.03.010
Ring D, McCarty LP, Campbell D, Jupiter JB (2004) Condylar blade plate fixation of unstable fractures of the distal ulna associated with fracture of the distal radius. J Hand Surg 29(1):103–109. doi:10.1016/j.jhsa.2003.10.019
De Smet L (2008) The DASH questionnaire and score in the evaluation of hand and wrist disorders. Acta Orthop Belg 74(5):575–581
May MM, Lawton JN, Blazar PE (2002) Ulnar styloid fractures associated with distal radius fractures: incidence and implications for distal radioulnar joint instability. J Hand Surg 27(6):965–971. doi:10.1053/jhsu.2002.36525
Seitz WH Jr, Raikin SM (2007) Resection of comminuted ulna head fragments with soft tissue reconstruction when associated with distal radius fractures. Tech Hand Up Extrem Surg 11(4):224–230. doi:10.1097/BTH.0b013e31805752f8
Foster BJ, Bindra RR (2012) Intrafocal pin plate fixation of distal ulna fractures associated with distal radius fractures. J Hand Surg 37(2):356–359. doi:10.1016/j.jhsa.2011.11.013
Ruchelsman DE, Raskin KB, Rettig ME (2009) 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) 4(4):391–396. doi:10.1007/s11552-009-9175-x
Carlsen BT, Dennison DG, Moran SL (2010) Acute dislocations of the distal radioulnar joint and distal ulna fractures. Hand Clin 26(4):503–516. doi:10.1016/j.hcl.2010.05.009
Solan MC, Rees R, Molloy S, Proctor MT (2003) Internal fixation after intra-articular fracture of the distal ulna. J Bone Joint Surg Br 85(2):279–280
Park MJ, Kim JP (2008) Reliability and normal values of various computed tomography methods for quantifying distal radioulnar joint translation. J Bone Joint Surg Am 90(1):145–153. doi:10.2106/JBJS.F.01603
Souer JS, Ring D, Matschke S, Audige L, Marent-Huber M, Jupiter JB, Group APODRS (2009) Effect of an unrepaired fracture of the ulnar styloid base on outcome after plate-and-screw fixation of a distal radial fracture. J Bone Joint Surg Am 91(4):830–838. doi:10.2106/JBJS.H.00345
Kim JK, Koh YD, Do NH (2010) Should an ulnar styloid fracture be fixed following volar plate fixation of a distal radial fracture? J Bone Joint Surg Am 92(1):1–6. doi:10.2106/JBJS.H.01738
Ring D (2005) Nonunion of the distal radius. Hand Clin 21(3):443–447. doi:10.1016/j.hcl.2005.01.005
Lee SK, Kim KJ, Park JS, Choy WS (2012) Distal ulna hook plate fixation for unstable distal ulna fracture associated with distal radius fracture. Orthopedics 35(9):e1358–e1364. doi:10.3928/01477447-20120822-22
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Han, S.H., Hong, I.T. & Kim, W.H. LCP distal ulna plate fixation of irreducible or unstable distal ulna fractures associated with distal radius fracture. Eur J Orthop Surg Traumatol 24, 1407–1413 (2014). https://doi.org/10.1007/s00590-014-1427-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00590-014-1427-y