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The management of distal ulnar fractures in adults: a review of the literature and recommendations for treatment.

Logan AJ, Lindau TR - Strategies Trauma Limb Reconstr (2008)

Bottom Line: The distal ulna represents the fixed point around which the radius and the hand acts in daily living.The significance of distal ulnar fractures is often not appreciated and often results in inadequate treatment in comparison to its larger counterpart; the radius.This paper aims to critically review the current literature and combine it with treatment suggestions based on the experience of the authors to help guide investigation and management of these often complex injuries.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK, andrewj.logan@btinternet.com.

ABSTRACT
The distal ulna represents the fixed point around which the radius and the hand acts in daily living. The significance of distal ulnar fractures is often not appreciated and often results in inadequate treatment in comparison to its larger counterpart; the radius. There is little guidance in the current literature as how to manage these fractures and their associated injuries. This paper aims to critically review the current literature and combine it with treatment suggestions based on the experience of the authors to help guide investigation and management of these often complex injuries.

No MeSH data available.


Related in: MedlinePlus

An ulnar styloid base fracture with more than 2-mm initial displacement
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Fig3: An ulnar styloid base fracture with more than 2-mm initial displacement

Mentions: We found 5 prospective and 11 retrospective articles as well as two case reports that dealt with ulnar styloid fractures (Table 1). Ulnar styloid fractures seldom occur alone. More than 40% (range 21–61%) of distal radius fractures have an associated ulnar styloid fracture [11–17] (This increases to 86% if the radial fracture is intra-articular [18]). If the ulnar styloid fracture is associated with a distal radius fracture, the ulnar styloid fracture will reduce with reduction of the distal radius in many cases [19] (Fig. 2). In such circumstances they can be treated with an above elbow cast for 6 weeks [20]. Obviously, exact restoration of the radius fracture around the sigmoid notch is of paramount importance for DRU-joint stability [21]. In a retrospective study of 71 ulnar styloid fractures in 130 patients with distal radial fractures, the wrists had significantly greater instability of the DRU-joint if the ulnar styloid fracture was >2 mm displaced initially [11] (Fig. 3). This was even more obvious if the fracture was at the base of the ulnar styloid [11] as there was likely to have been an associated detachment of the ulno-radial ligament (Fig. 1). This is important as 41% of all ulnar styloid fractures occur at its base [11] and contribute to a poorer outcome because of their effect on DRU-joint instability [22]. Fixation of ulnar styloid base fractures with a single wire has been shown to restore DRU-joint stability in a small case series (n = 6) [10]. Fractures through the tip of the styloid are likely to be stable [20] (Fig. 4) and do not require fixation as the ulno-radial ligament remains attached to the ulnar head at the base of the styloid.Fig. 2


The management of distal ulnar fractures in adults: a review of the literature and recommendations for treatment.

Logan AJ, Lindau TR - Strategies Trauma Limb Reconstr (2008)

An ulnar styloid base fracture with more than 2-mm initial displacement
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2553431&req=5

Fig3: An ulnar styloid base fracture with more than 2-mm initial displacement
Mentions: We found 5 prospective and 11 retrospective articles as well as two case reports that dealt with ulnar styloid fractures (Table 1). Ulnar styloid fractures seldom occur alone. More than 40% (range 21–61%) of distal radius fractures have an associated ulnar styloid fracture [11–17] (This increases to 86% if the radial fracture is intra-articular [18]). If the ulnar styloid fracture is associated with a distal radius fracture, the ulnar styloid fracture will reduce with reduction of the distal radius in many cases [19] (Fig. 2). In such circumstances they can be treated with an above elbow cast for 6 weeks [20]. Obviously, exact restoration of the radius fracture around the sigmoid notch is of paramount importance for DRU-joint stability [21]. In a retrospective study of 71 ulnar styloid fractures in 130 patients with distal radial fractures, the wrists had significantly greater instability of the DRU-joint if the ulnar styloid fracture was >2 mm displaced initially [11] (Fig. 3). This was even more obvious if the fracture was at the base of the ulnar styloid [11] as there was likely to have been an associated detachment of the ulno-radial ligament (Fig. 1). This is important as 41% of all ulnar styloid fractures occur at its base [11] and contribute to a poorer outcome because of their effect on DRU-joint instability [22]. Fixation of ulnar styloid base fractures with a single wire has been shown to restore DRU-joint stability in a small case series (n = 6) [10]. Fractures through the tip of the styloid are likely to be stable [20] (Fig. 4) and do not require fixation as the ulno-radial ligament remains attached to the ulnar head at the base of the styloid.Fig. 2

Bottom Line: The distal ulna represents the fixed point around which the radius and the hand acts in daily living.The significance of distal ulnar fractures is often not appreciated and often results in inadequate treatment in comparison to its larger counterpart; the radius.This paper aims to critically review the current literature and combine it with treatment suggestions based on the experience of the authors to help guide investigation and management of these often complex injuries.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK, andrewj.logan@btinternet.com.

ABSTRACT
The distal ulna represents the fixed point around which the radius and the hand acts in daily living. The significance of distal ulnar fractures is often not appreciated and often results in inadequate treatment in comparison to its larger counterpart; the radius. There is little guidance in the current literature as how to manage these fractures and their associated injuries. This paper aims to critically review the current literature and combine it with treatment suggestions based on the experience of the authors to help guide investigation and management of these often complex injuries.

No MeSH data available.


Related in: MedlinePlus