J Korean Orthop Assoc.  2013 Apr;48(2):151-156. 10.4055/jkoa.2013.48.2.151.

Treatment of Ulnar Fractures Combined with Distal Radius Fracture

• Kim JK
• Kim JO
• Yun YH

• KMID: 1424109
• DOI: http://doi.org/10.4055/jkoa.2013.48.2.151

Abstract

Approximately 5-6% of distal radius fractures have a concomitant distal ulnar fracture, this incidence is more frequent in osteoporotic elderly patients. When the distal ulnar fracture is stable after fixation of the distal radius fracture, the distal ulnar fracture can be managed with cast immobilization. However, when the distal ulnar fracture shows malalignment or instability, an operative method should be used. The operative method for distal ulnar fracture includes internal fixation using a K-wire, intramedullary nail, or plates and salvage procedures including ulnar head resection or Sauve-Kapandji procedure. Approximately 50% of distal radius fractures are combined with ulnar styloid process fracture. Although approximately 50-70% of ulnar styloid process fractures result in nonunion if they are not treated by an operative method, they tend to be asymptomatic. Recent studies of distal radius fracture treated using a volar locking plate have generally reported that neither the presence nor the size of concomitant ulnar styloid fracture has an effect on clinical outcome.

Keyword

distal radius fracture; distal ulnar fracture; ulnar styloid process fracture

MeSH Terms

Aged
Head
Humans
Immobilization
Incidence
Nails
Radius
Radius Fractures

Figure

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  Figure 1 Classification of distal ulnar fracture proposed. Cited from the article of Biyani et al. (Fig. 1) with permission.2)

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  Figure 2 In the comprehensive classification system, the associated fracture of the distal ulna is classified according to a Q system.

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  Figure 3 A 74-year-old female patient treated with anatomical locking plate fixation for a concomitant distal ulnar metaphyseal fracture. (A) Preoperative radiograph of the wrist. (B) Radiograph taken at three months after surgery.

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  Figure 4 A 68-year-old female patient who received conservative treatment for a concomitant distal ulnar metaphyseal fracture. (A) Preoperative radiograph of the wrist. (B) Radiograph taken immediately after surgery. (C) Radiograph taken at one year after surgery.

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