Treatment of Ulnar Fractures Combined with Distal Radius Fracture

Jae Kwang Kim; Jong-Oh Kim; Yeo-Hon Yun

doi:10.4055/jkoa.2013.48.2.151

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Kim, Kim, and Yun: Treatment of Ulnar Fractures Combined with Distal Radius Fracture

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Treatment of Distal Radius Fracture and Combined Injuries

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2013; 48(2): 151-156.

Published online: 25 April 2013

DOI: https://doi.org/10.4055/jkoa.2013.48.2.151

Treatment of Ulnar Fractures Combined with Distal Radius Fracture

Jae Kwang Kim, M.D., Ph.D., Jong-Oh Kim, M.D., Ph.D., Yeo-Hon Yun, M.D., Ph.D.

Department of Orthopedic Surgery, Ewha Womans University School of Medicine, Seoul, Korea.

Correspondence to: Jae Kwang Kim, M.D., Ph.D. Department of Orthopedic Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 158-710, Korea. TEL: +82-2-2650-2591, FAX: +82-2-2642-0349, kimjk@ewha.ac.kr

Received 31 January 2013 Revised 12 February 2013 Accepted 20 February 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: distal radius fracture, distal ulnar fracture, ulnar styloid process fracture

Figures and Tables

Figure 1

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

Figure 2

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

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.

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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