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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

From the Departments of Orthopaedic Surgery, Minoh City Hospital, Ryokufukai Hospital, and Osaka University Graduate School of Medicine, Japan

Correspondence: J. Namba, MD, PhD, Department of Orthopaedic Surgery, Minoh City Hospital, 5-7-1, Kayano, Minoh, Osaka 562-8562, Japan. Tel.: +81-72-728-2001; fax: +81-72-728-8232. E-mail:bpdum202{at}tcct.zaq.ne.jp.

There is no clear consensus about the best management of intra-articular distal ulnar fractures associated with distal radial fractures in older adults. We describe a treatment wherein the distal radial fractures were securely fixed with a palmar plate, leaving the associated ulnar fractures unfixed. The wrists of 14 patients with a mean age of 74 years were reviewed at an average of 18 months after surgery. The results were excellent in 11 cases and good in three, according to the modified Gartland and Werley score. All fracture sites displayed union, and there was no instability of the distal radioulnar joint. A widening of the distal radioulnar joint space was present in one wrist. Angular deformity of the distal ulnar metaphysis was seen in five wrists. This treatment could be an alternative to open reduction with internal fixation for intra-articular distal ulnar fractures in older adults.

Key Words: ulnar head fracture • conservative treatment • distal radial fracture • distal ulnar fracture

This version was published on October 1, 2009

Journal of Hand Surgery (European Volume), Vol. 34, No. 5, 592-597 (2009)
DOI: 10.1177/1753193409103728


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