Clin Orthop Surg.  2020 Mar;12(1):130-134. 10.4055/cios.2020.12.1.130.

Intramedullary Stabilization Technique Using Headless Compression Screws for Distal Ulnar Fractures

• Oh JR
• Park J

• KMID: 2470061
• DOI: http://doi.org/10.4055/cios.2020.12.1.130

Abstract

Distal ulnar fractures are commonly accompanied by distal radial fractures, and several treatment options such as plate osteosynthesis and pinning with Kirschner's wires are used. In this study, we present a technique using headless compression screws to achieve bony union of distal ulnar fractures. From November 2016 to November 2018, we treated 11 patients with distal ulnar fractures combined with distal radial fractures with headless compression screws (DePuy Synthes). Patients were instructed to maintain a short-arm splint for less than two weeks after the treatment. The mean time to bony union was 6.5 weeks, mean Quick Disabilities of the Arm, Shoulder, and Hand score was 14.6 points, and mean visual analog scale score was 1.09 points. Full range of motion was possible in all directions after surgery and no specific complications were observed. The suggested technique allows minimal incision and minimally invasive intramedullary fixation and can promote bony union in a simple way without specific complications.

Keyword

Ulna; Radius; Fracture; Wrist; Intramedullary; Screw

MeSH Terms

Arm
Hand
Humans
Radius
Range of Motion, Articular
Shoulder
Splints
Ulna
Visual Analog Scale
Wrist

Figure

• 

  Fig. 1 (A) A guide wire was inserted from the ulnar head on the dorsal aspect to the ulnar distal shaft (case I). (B) A 4-mm drill bit was inserted through the guide wire. (C) The 4.5-mm headless compression screw was inserted along the guide wire.

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  Fig. 2 (A) Radiographs showing an AO type C distal ulnar fracture with comminution. Open wound was noted on the ulnar aspect of the wrist. (B) Radiographs showing internal fixation of the distal radius with use of Arix Volar Distal Radius anatomical plate, screws, and K-wires and fixation of the ulnar neck with use of DePuy Synthes headless compression screw. Ulnar fixation could be done regardless of the open wound. (C) Six months after the operation, complete bony union was achieved. Lt: left.

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  Fig. 3 (A) Radiographs showing distal ulnar intra-articular fracture (AO type C). (B) Radiographs showing internal fixation of both distal radius and ulnar: Arix Volar Distal Radius anatomical plate and screws for distal radius; DePuy Synthes headless compression screw for the ulnar neck. (C) Computed tomographic scans showing the intra-articular fracture pattern with the ulnar neck fracture line extending to the radial sigmoid notch in the axial plane. (D) Clinical photos showing that full range of motion of the wrist is possible in all directions after bony union. Lt: left.

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