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Journal articles on the topic 'Radius-Ulna Fractures'
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Lutsky, Kevin F., Ludovico Lucenti, and Pedro K. Beredjiklian. "Outcomes of Distal Ulna Fractures Associated With Operatively Treated Distal Radius Fractures." HAND 15, no. 3 (2018): 418–21. http://dx.doi.org/10.1177/1558944718812134.
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Background: The purpose of this study was to report outcomes in patients with nonstyloid distal ulna fractures treated in conjunction with open reduction internal fixation (ORIF) of distal radius fractures. Methods: A retrospective review of all patients who had undergone ORIF of a distal radius fracture over a 5-year period at a single institution was performed. Radiographic review was performed to identify patients with a concomitant fracture of the distal ulna. Radiographs were examined to determine whether and how the distal ulna fracture was stabilized and to assess healing of the distal ulna. Range of motion (ROM) was determined by review of the patients’ charts. All skeletally mature patients with distal ulna fractures (not including isolated styloid fractures) undergoing surgical fixation of the distal radius fracture were included. Patients were excluded if follow-up was inadequate. There were 172 fractures of the distal ulna meeting the inclusion criteria. Seven patients were excluded. There were 91 patients treated without ulna fixation (ulna-no) and 74 patients treated with ulna fixation (ulna-yes). Results: Seventy-two (97%) of the ulna-yes patients healed. All patients in the ulna-no group healed. The only significant difference in ROM was in pronation, although the magnitude of this difference was relatively small. Conclusions: Fractures of the distal ulna have high rates of healing and result in equivalent motion regardless of whether the distal ulna is treated operatively. Routine surgical fixation of concomitant distal ulna fractures during distal radius ORIF does not appear to be necessary.
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Mehmet, Zeki Yılmaz Deveci, Tayer İşler Cafer, Enes Altuğ Muhammed, et al. "Treatment of Radius and Ulna Fractures in Toy and Miniature Breed Dogs (22 Cases)." International Journal of Veterinary and Animal Research 5, no. 2 (2022): 66–72. https://doi.org/10.5281/zenodo.7020400.
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Radial and ulnar fractures are common in small animals. Especially toy and miniature breed dogs are at high risk of incidence. Although there are plenty of studies on the treatment of radius and ulna fractures in small animals, studies related to the radius and ulna fractures in toy and miniature breed dogs are limited. The objective of this study was to report the diagnostic information and treatment outcome of radial and ulnar fracture treatment in toy and miniature breed dogs. Radius and ulna fractured 22 toy and miniature breed dogs were included in the study. Clinical findings, radiographic images, treatment applications, prognosis and outcomes were evaluated. As a treatment method, external coaptation in 5 extremities and surgical reduction and osteosynthesis in 17 extremities were performed. Out of 5 dogs who underwent external coaptation, 4 had good outcome and 1 had malunion. Out of 17 patients which underwent surgical treatment, 13 had a good outcome, 2 had nonunion, 1 had surgical site infection, and 1 had malunion and implant failure. As a result, original data on the etiology, diagnosis, treatment, prognosis evaluations, and surgical outcomes of radius and ulna fractures of toy and miniature breed dogs were presented. External coaptation considered could be successful in closed and undislocated radius and ulna fractures of toy and miniature breed dogs. However, the surgical approach and osteosynthesis performing are considered essential in dislocated, comminuted, complicated fractures, or open fractures. Further prospective studies are needed to compare specific surgical treatment methods.
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Konstantelos, Natalia, Andrea M. Burden, Angela M. Cheung, Sandra Kim, Paul Grootendorst, and Suzanne M. Cadarette. "Comparison of Fracture Identification Using Different Definitions in Healthcare Administrative (Claims) Data." Pharmacy 11, no. 2 (2023): 53. http://dx.doi.org/10.3390/pharmacy11020053.
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We identified inconsistency in fracture definitions in a prior review of studies that utilized claims data. Here, we aimed to compare fracture rates estimated using thirteen hip and seven radius/ulna fracture definitions. Our primary analysis compared results in a cohort of 120,363 older adults treated with oral bisphosphonates for ≥3 years. The most inclusive definition (hip: inpatient or emergency diagnosis; radius/ulna: inpatient, emergency, or outpatient diagnosis) served as a referent to compare the number and proportion of fractures captured. In sensitivity analyses, we considered a 180-day washout, excluded fractures associated with trauma; and hip only, excluded: (1) subtrochanteric fractures, and (2) hip replacement procedures. Hip fractures varied by definition in number (52–8058) and incidence (0.7–111.8/10,000 person-years). The second most inclusive definition required one inpatient diagnosis and identified 8% fewer hip fractures than the referent. Excluding hip replacements missed 33% of hip fractures relative to the primary analysis. Radius/ulna fractures also ranged in number (1589–6797) and incidence (22.0–94.3/10,000 person-years). Outpatient data were important, when restricted to inpatient or emergency data, only 78% of radius/ulna fractures were identified. Other than hip replacement procedures, sensitivity analyses had minimal impact on fracture identification. Analyses were replicated in a cohort of patients treated with long-term glucocorticoids. This study highlights the importance and impact of coding decisions on fracture outcome definitions. Further research is warranted to inform best practice in fracture outcome identification.
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Malak, Anthony, and Andrew S. Levien. "Application of Double-Threaded Locking Adaptation Plates used to Repair a Radius and Ulna Fracture in a Domestic Rabbit (Oryctolagus Cuniculus)." VCOT Open 03, no. 02 (2020): e182-e186. http://dx.doi.org/10.1055/s-0040-1721662.
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Abstract Objective This study is a case description of the clinical application of locking plates to repair fractures in the radius and ulna of a 9-month-old, male domestic rabbit. Study Design This study is a case report. Results Double-threaded locking adaptation plates of 1.5 mm were fixated to the radius and ulna of the rabbit using the principles of orthogonal plating. Radiographs of the left radius and ulna were obtained at 8 weeks postoperatively depicting complete osseous union of the fracture and no implant complications were observed. Clinical Significance The authors describe the first clinical report of 1.5 mm locking adaptation plates having been used in repairing radius and ulna fractures in a domestic rabbit.
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Hulse, D. A., S. C. Kerwin, W. B. Saunders, and T. H. Witsberger. "Minimally invasive application of a radial plate following placement of an ulnar rod in treating antebrachial fractures." Veterinary and Comparative Orthopaedics and Traumatology 23, no. 06 (2010): 459–67. http://dx.doi.org/10.3415/vcot-10-01-0001.
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Summary Objective: To describe a surgical technique for placement of a minimally invasive radial plate following application of an ulnar rod (MIPR) for treatment of antebrachial fractures. Methods: Medical records (November 2005-June 2009) were searched to identify dogs with diaphyseal radius and ulna fractures stabilised by MIPR. Data retrieved included signalment, weight, limb affected, cause of injury, open versus closed fracture, number of fragments, implant size, number of screws used and cortices engaged, number of open screw holes, operative time, rod removal, complications and time to radio-graphic healing. To be included, dogs had to have evidence of radiographic healing during follow-up. Results: Eight dogs with diaphyseal radius and ulna fractures treated with MIPR were included in the case series. All fractures were due to trauma and two fractures were open (grade 1). Rod loosening and osteomyelitis of the ulna occurred in one case which subsequently resolved with rod removal. Healing occurred in all cases with no implant failures. Median time to radiographic union was 10.5 weeks (mean ± SD = 17 ± 15 weeks range 4–52 weeks). Clinical relevance: Use of MIPR constructs on diaphyseal fractures of the radius and ulna is an effective technique for managing these fractures using principles of biological osteo-synthesis. An intramedullary rod in the ulna assists with fracture reduction and stabilisation and rod removal is recommended once fracture healing has occurred.
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Nithin, Gangadharan. "Patterns of Radius-Ulna Fractures at Tertiary Care Center Among Pediatric Patients." International Journal of Pharmaceutical and Clinical Research 14, no. 9 (2022): 1189–93. https://doi.org/10.5281/zenodo.13344942.
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<strong>Background:</strong> The pediatric radius-ulna fractures are managed by conservative treatment methods such as closed reduction and casting and other methods are operative fixation with flexible plates and nails. In previous studies it was reported that radius-ulna fractures are usually occurred probably due to poor bone mineralization, Vitamin D deficiency and due to decreased physical activity. <strong>Material & Methods:</strong> 50 Patients below 18 years of the age and presented at hospital with radius-ulna fracture were enrolled from emergency and outdoor departments by simple random sampling. Institutional Ethics Committee Clearance was obtained before start of study and written and informed consent for the procedure was obtained from all the patients. <strong>Results:</strong> In the present study, out of the total study participants, most of the cases had middle third fractures among 29 (58%) patients which was followed by fractures of proximal one third in 12 (24%) patients and fractures of distal one third was found among 09 (18%) patients. All of the total study participants had radial fractures at the presentation of primary fracture. Out of the total study participants 38 (76%) patients had associated ulna fracture. Out of the total study participants Radius was reported to be involved in all patients of re-fractures. Out of the total study participants, tricortical union was seen in all patients at the end of 8 weeks. In the present study, out of the total study participants, none of the patients developed post-operative infections and neurologic deficits. <strong>Conclusion: </strong>We concluded from the present study that pediatric radius-ulna fractures can be managed by both conservatively and operatively with good outcome and results were similar to the treated primary fractures.
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BIYANI, A., A. J. M. SIMISON, and L. KLENERMAN. "Fractures of the Distal Radius and Ulna." Journal of Hand Surgery 20, no. 3 (1995): 357–64. http://dx.doi.org/10.1016/s0266-7681(05)80094-4.
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Associated fractures of the distal ulnar metaphysis were present in 19 of 320 distal radial fractures requiring either closed manipulation or surgical treatment over a 2-year period. Four morphological patterns of ulnar fracture were encountered, the commonest being the type 1 simple extra-articular fracture of the distal end of ulna with minimal comminution (eight out of 19). 15 patients were treated conservatively and two each were treated by internal and external fixation. 15 patients were reviewed after a mean follow-up of 23.8 months and there were four excellent, five good, five fair clinical results and one poor result. Radiographically the distal radio-ulnar joint (DRUJ) was normal in eight wrists, but longitudinal or horizontal disruption of the DRUJ was present in seven wrists. Fracture callus encroached on the DRUJ in three patients, who also had limitation of forearm rotation. Two comminuted ulnar fractures (type 4) developed non-union, but both patients had full forearm rotation, in contrast to restriction of forearm rotation in four out of five patients with type 1 fractures.
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Gaurav, Parikh, Leuva Vipul, Ansari Ejajahmed, and Rangwala Avi. "Analysis of Outcomes between Intramedullary and Extramedullary Fixation of Fracture of Radius and Ulna." International Journal of Pharmaceutical and Clinical Research 15, no. 9 (2023): 353–59. https://doi.org/10.5281/zenodo.11340214.
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<strong>Introduction: </strong>The radius and ulna are the most usually fractured upper extremity bones owing to falls on extended hands. Imaging confirms the diagnosis and children often have buckle or greenstick fractures treated by angulation. “Distal radius fractures” in adults are commonly splinted. Midshaft ulna fractures may need surgery or immobilisation. Surgery is frequently needed for many fractures. Elbow function is important with radial head fractures. <strong>Aims and Objectives:</strong> This study compares intramedullary and extramedullary forearm fracture fixation procedures. <strong>Method: </strong>This prospective study at Sheth L.G. Hospital in Ahmedabad, India, examined 18 to 65-year-olds with concurrent closed radius and ulna shaft fractures from July 2021 to May 2023. The surgery involved open reduction and dynamic compression plate or intramedullary nailing for internal fixation. Fracture union, comorbidities, and function were examined. Its rigorous methodology allowed a meaningful comparison of intramedullary and extramedullary fixation for both bone forearm fractures, providing clinical insights. <strong>Result:</strong> Table 1 lists the anterior fascial compartment’s forearm muscles’ origins, insertions, and nerve supplies. These muscles include the Pronator Quadratus, which originates from the ulna’s anterior surface and enters into the radius in Table 2. Table 3 shows primary function is forearm pronation, twisting the palm downward or posteriorly for actions like turning a doorknob or altering hand orientation. Innervated by the median nerve’s anterior interosseous branch (C8, T1). This muscle coordinates forearm and hand movements in Table 4. <strong>Conclusion: </strong>Our study found that intramedullary nail fixation for forearm fractures is comparable to plate fixation and has fewer complications.
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Kim, Jae Kwang, Jong-Oh Kim, and Yong-Do Koh. "Management of Distal Ulnar Fracture Combined with Distal Radius Fracture." Journal of Hand Surgery (Asian-Pacific Volume) 21, no. 02 (2016): 155–60. http://dx.doi.org/10.1142/s2424835516400075.
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The distal ulna is composed of the ulnar styloid, ulnar head, and distal ulnar metaphyseal area. Most of distal ulnar metaphyseal fractures are associated with distal radius fractures and this incidence tends to be greater in osteoporotic elderly. Consideration of the treatment of distal ulna metaphyseal fracture should be addressed after treating a distal radius fracture. If it is stable, cast immobilization is preferred, however, if it shows malalignment or instability, an operative method should be considered. More than half of distal radius fractures are combined with an ulnar styloid fracture, and considerable cases of ulnar styloid fractures result in nonunion. However, ulnar styloid nonunion usually does not cause any problems on the wrist. Recent studies of distal radius fractures treated using a volar locking plate have reported that neither the initial displacement nor the size of a concomitant ulnar styloid fracture affects clinical outcome, which suggests surgical approaches may usually not be indicated for ulnar styloid fractures.
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Mane, Akash Nagnath, Neel Kamal Sourav, Ankit B. Waghela, and Vijay M. Panchnadikar. "Single dorsal incision approach for plate fixation of radius ulna midshaft fracture; interesting case report." Indian Journal of Orthopaedics Surgery 9, no. 1 (2023): 34–37. http://dx.doi.org/10.18231/j.ijos.2023.009.
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Radius and ulna shaft fractures, also known as both bone forearm fractures, are common fractures caused due to direct or indirect trauma. Open reduction and internal fixation with plating by two separate incisions is a standard and widely accepted mode of fixation. We report a case where we approached the fracture with a single dorsal incision. An eighty years old female had fractures of both radius and ulna shaft with Gustilo Anderson type two open injury. We managed the patient with single-stage debridement, open reduction, and dynamic compression plate (DCP) fixation of both bones with a single dorsal curvilinear incision and followed up postoperatively for one year. At the end of the last follow-up, the patient had no pain with a full range of movement. There were no wound-related issues. Radiologically complete union occurred without complications mentioned in the literature, such as synostosis.: We found that under specific circumstances such as open injury where two separate incisions for radius and ulna are inappropriate, a single dorsal curvilinear incision for radius and Ulna midshaft fractures is a safe and effective alternative method.
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Ghimire, N., S. Uprety, and A. Lamichhane. "Risk factors for redisplacement in pediatric distal radius fractures after closed reduction and cast immobilisation." Journal of Institute of Medicine Nepal 38, no. 1 (2016): 81–84. http://dx.doi.org/10.59779/jiomnepal.732.
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Introducation: Pediatric distal radius fractures are one of the most common fractures that we see in our practice. The primary modality of treatment of the displaced fractures of distal radius in children is closed reduction and immobilization in cast. Loss of alignment in cast after an acceptable reduction is common. Twenty one to fifty percent rates of redisplacement in cast after acceptable initial reduction have been reported in literature. Methods: This prospective study included 58 fractures of distal radius and distal third shaft of radius in 57 children with radiologically open physis. Age, gender, initial displacement, associated fracture of the ulna, adequacy of reduction, cast index and gap index were evaluated as possible risk factors for redisplacement in cast. Results: A redisplacement rate of 34.48%was found in distal radius fractures of children after acceptable initial closed reduction and immobilization in cast. Initial complete displacement, degree of initial translation in coronal and sagittal plane, degree of initial angulation in the coronal plane, associated fracture of the ulna, non anatomical initial reduction and cast index were found to be significant risk factors for redisplacement. Age, gender, initial angulation in the sagittal plane and gap index were insignificant risk factors. Conclusion: Distal radius fractures in children have high rate of redisplacement in cast. Fractures with initial complete displacement, fractures with associated fracture of ulna and non-anatomically reduced fractures should either be treated by primary closed reduction and percutaneous pinning or must be followed very carefully in cast treatment. Cast index rather than gap index is a better predictor of loss of reduction in cast.
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Nişancı, Onur Seçgin, Birsen Özyurt, and Murat Uysal. "Anatomical Examination of Humerus, Radius and Ulna Fractures in 18-64 Year Old Individuals Applying to the Emergency Department." Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 14, no. 1 (2025): 32–40. https://doi.org/10.37989/gumussagbil.1609694.
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In this study, it was aimed to anatomically examine the fractures of the humerus, radius and ulna, which have a significant admission rate in emergency departments, and to explain the relationship between different fracture parameters. The anatomical distribution of humerus, radius and ulna fractures in 239 patients who presented to xxx University Hospital between 2012 and 2018 were retrospectively investigated. Participants were between the ages of 18-64 years and were diagnosed with a fracture in only one bone. It has been found that fractures are more common in men and in the 18-44 age group (p
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Ajit Singh, Vivek, Tan Yong Jia, Rupini Devi Santharalinggam, and Jayaletchumi Gunasagaran. "Relationship of ulna styloid fracture to the distal radio-ulnar joint stability. A clinical, functional, and radiographic outcome study." PLOS ONE 18, no. 1 (2023): e0279210. http://dx.doi.org/10.1371/journal.pone.0279210.
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Background Ulna styloid fracture occurs approximately about 55% of all distal end of radius fractures. However, the clinical and functional outcome of these fractures remains indefinite. Results Only 56 patients with distal radius fractures had concomitant ulna styloid fractures. The mean age was 32 years (range: 18–69; SD: ± 12.7). The majority were men. The mean time from injury was 18.7 months (range: 6–84; SD: ± 13.3). The most common was Frykman 2, followed by 6, type 8, and type 4. All were closed fractures; 60.7% were base, and 39.3% were tip fractures. 50% were treated with casting, 48.3% plating, and 1.8% external fixation. The mean period of casting was 7.67 weeks (range: 4–16; SD ± 3.1). The ulna styloid was united in 35.7%. There is no significant difference in the range of movement between those with ulna styloid union and non-union. The Ballottement test and Piano key sign was statistically insignificant between both groups. All the displacements were dorsal except in 1 case. The mean displacement of ulna styloid is 1.88mm (SD±1.08, Range: 0.20–4.60mm). The mean VAS score at rest and work is not statistically significant. The mean grip strength and functional score (DASH) are similar in both groups. Conclusion Ulna styloid fractures do not contribute to the DRUJ instability and the status of the union of the ulna styloid and the site of the ulna styloid fracture (tip or base) did not have a bearing on the range of movement and functional status of the affected wrist. Temporary DRUJ immobilization might allow TFCC recovery.
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Yoneda, H., and K. Watanabe. "Primary excision of the ulnar head for fractures of the distal ulna associated with fractures of the distal radius in severe osteoporotic patients." Journal of Hand Surgery (European Volume) 39, no. 3 (2013): 293–99. http://dx.doi.org/10.1177/1753193413504160.
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We performed primary excision of the ulnar head on 23 patients over 70 years of age with severe comminuted fractures of both the distal radius and ulna. The distal radius fracture was fixed rigidly with a volar locking plate, and the ulnar head was resected at the fracture site. All the distal radial fractures united without major complications. The mean wrist flexion/extension arc was 122°, the mean pronation/supination arc was 164°, and grip strength was 69% of that on the contralateral side. All patients returned to their daily activities within a short time without any additional surgical treatment. For elderly patients, primary excision of the ulnar head is an effective treatment for comminuted distal radius and ulna fractures.
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ALAM, WAQAR, FAAIZ ALI SHAH, ZAFAR DURRANI, Zahid Askar, Muhammad Ayaz Khan, and Sikandar Hayat. "UNSTABLE FRACTURE OF RADIUS AND ULNA." Professional Medical Journal 18, no. 02 (2011): 323–27. http://dx.doi.org/10.29309/tpmj/2011.18.02.2102.
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Objectives: To know the functional outcome of Intramedullary Kirschner Wire fixation of unstable Radius-Ulna fractures in children. Study Design: Descriptive study. Period: 27/03/2009 to 26/03/2010. Setting: Department of Orthopedic and Trauma, Khyber Teaching Hospital, Peshawar. Patients and Methods: All patients were admitted from OPD . Children less than 16 years with Unstable Radius- Ulna fractures were included in the study. Patients with open fractures and adults with polytrauma were excluded from the study. Unstable Radius-Ulna fractures were treated by Intramedullary Kirschner Wire fixation under general anesthesia and tourniquet control. Follow up till radiological and clinical union was done. K-wires were removed after healing of fractures. Patients were assessed functionally and radiologically and results were graded according to Price et al Criteria. Results: A total of 64 children with unstable radius and ulna fractures were included in the study. The age range was 6 to 15 years with average age of 10.41 years. 47 were male and 17 were female. The average time of radiological union was 7 weeks and K-wires were removed at 8 weeks time. At final assessment there were 47 Excellent, 10 Good and 7 Fair results. Conclusions: Excellent results can be achieved by Intramedullary K-Wires fixation. In children with unstable Radius-Ulna fractures. It should be the method of choice for treating these fractures.
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Nayar, Suresh K., Anne M. Kuwabara, José M. Flores, Greg M. Osgood, Dawn M. LaPorte, and Babar Shafiq. "Venous Thromboembolism in Upper Extremity Fractures." Journal of Hand Surgery (Asian-Pacific Volume) 23, no. 03 (2018): 320–29. http://dx.doi.org/10.1142/s2424835518500303.
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Background: Venous thromboembolism (VTE) has been studied in lower extremity fractures but little is known of its relation with upper extremity (UE) fractures. As an often overlooked but serious complication, VTE may compromise patient outcomes. Methods: Using data on inpatients (aged ≥ 18 years) at a level-I trauma center and patients in the National Surgical Quality Improvement Program database who sustained UE fractures (clavicle, humerus, or radius/ulna) and VTE in the same hospitalization between 2007 and 2014, the authors analyzed data on demographic characteristics, fracture type, VTE location (pulmonary embolism, lower extremity, or UE), VTE onset, polytrauma, operative or nonoperative management, comorbidities, and mortality. Results: Of 1984 inpatients with UE fractures at 1 instution, 9 experienced VTE on admission, and 17 (15 received thromboprophylaxis) experienced VTE during hospitalization, for an overall VTE rate of 1.3%. VTE occurred most often in patients with fractures of the proximal humerus (3.0%) followed by the clavicle (2.0%), midshaft humerus (1.9%), distal radius/ulna (0.95%), and distal humerus/elbow (0.36%) (p = 0.0035). There were no significant trends in the incidence of PE (p = 0.33) over the study period, but there was a sharp rise since 2011. In the national database, 42 of 11570 (0.36%) patients with UE fracture had VTE, with incidence by fracture location ranging from 0.14% (radius/ulna) to 0.98% (proximal humerus) (p = 0.00001). Predictors were chronic steroid use (odds ratio [OR] = 6.22, p = .030), inpatient status (OR = 4.09, p = .002), and totally disabled functional status (OR = 3.31, p = .021). Conclusions: VTE incidence was highest following proximal humerus or clavicle fractures and are rarely associated with radius/ulna fractures. There may have been a rise in the incidence of PE since 2007, warranting further investigation.
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Cappellari, F., B. Peirone, A. Ferretti, and L. Piras. "Treatment of fractures of the distal radius and ulna in toy breed dogs with circular external skeletal fixation: a retrospective study." Veterinary and Comparative Orthopaedics and Traumatology 24, no. 03 (2011): 228–35. http://dx.doi.org/10.3415/vcot-10-06-0089.
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SummaryObjective: To evaluate the effectiveness of circular external skeletal fixation (CESF) in treating fractures of the distal radius and ulna in toy breed dogs, and to document the type and frequency of complications associated with this technique.Methods: The medical records of small breed dogs with fractures of the distal radius and ulna admitted to the University of Turin and to the Clinica Ferretti between 2002 and 2009 were retrospectively reviewed. The criteria for inclusion of cases in the study were: body weight of 5 kg or less, transverse or short oblique fracture of the distal third of the radius and ulna, no previous repair attempts, and treatment with CESF as the sole method of fixation.Results: Twenty fractures in 16 dogs satisfied the criteria for inclusion into this study. No signs of infection or failure of fixation were detected in any case. Mean frontal plane alignment was 4.7° ± 2.7° and mean sagittal plane alignment was 12.7° ± 7.2°. Postoperative complications occurred in one patient. All fractures achieved union. Mean time until radiographic evidence of a bridging callus and subsequent implant removal was 71 days (range: 30–120).Conclusions: The results of this study support the use of CESF for treatment of fractures of the distal radius and ulna in toy breed dogs as an alternative to other methods of fracture fixation. However, this technique requires a series of follow-up examinations to evaluate the stability of the apparatus, the soundness of the wires and to determine the appropriate time for implant removal.
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Goring, R. L., J. J. Haan, and W. C. Renberg. "Repair of Diaphyseal Radius and Ulna Fractures Using a Modified Type I External Skeletal Fixator and Ulnar Intramedullary Pin." Veterinary and Comparative Orthopaedics and Traumatology 09, no. 01 (1996): 29–35. http://dx.doi.org/10.1055/s-0038-1632498.
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SummaryModified type I external skeletal fixation of the radius (using a curved connecting bar and unique pin placement) was combined with intramedullary pinning of the ulna to repair eight ipsilateral radius and ulna fractures in dogs. The intramedullary ulnar pin was placed first, aligning the radial fragments, which allowed closed application of the radial fixation. External skeletal fixation was designed to minimize soft tissue trauma and achieve a uniform boneto- connecting-bar distance. Seven of eight fractures healed in eight to twelve weeks with the technique described. The eighth case needed additional fixation following complications associated with the severity of the injury. Results of this study demonstrate that the technique is a suitable alternative for repair of the fracture types included.A modified type I external skeletal fixator and intramedullary pin was successfully used to repair radius and ulna fractures. The technique was developed in order to provide technically simple but rigid stabilization that minimized soft tissue disruption. The technique is described along with the results in a variety of fracture types.
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Sengodan, Mugundhan M. "Malunited Isolated Intra-articular Fracture of Ulnar Head." Journal of Orthopedics and Joint Surgery 2, no. 2 (2020): 74–78. http://dx.doi.org/10.5005/jp-journals-10079-1024.
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ABSTRACT Fractures of distal ulna are often associated with fracture distal radius. Isolated intra-articular fractures of ulnar head have very rarely been reported in the literature. Displaced intra-articular fractures of ulna head should be treated properly so that the distal radio ulnar joint congruence is maintained. I am reporting a case of malunited isolated intra-articular fracture of ulnar head in young girl which was treated by open reduction and internal fixation. Logan and Lindau in their review of literature and recommendations for treatment of distal ulna fractures in adults found only few case reports. All those reported cases were treated soon after the injury. This case has been presented not only for its rarity but also to recognize the importance of managing the intra-articular fractures properly even in distal ulna. How to cite this article: Sengodan MM. Malunited Isolated Intra-articular Fracture of Ulnar Head. J Orth Joint Surg 2020;2(2):74–78.
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Abboudi, Jack, Scott M. Sandilands, C. Edward Hoffler, William Kirkpatrick, and William Emper. "Technique for Intramedullary Stabilization of Ulnar Neck Fractures." HAND 13, no. 5 (2017): 563–71. http://dx.doi.org/10.1177/1558944717725376.
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Background: Distal ulna fractures at the ulnar neck can be seen in association with distal radius fractures, and multiple techniques have been described to address the ulnar neck component of these injuries. We have found that treatment of ulnar neck fractures can be challenging in terms of anatomy and fracture fixation. We present a new percutaneous fixation technique for ulnar neck fractures commonly seen with distal radius fractures. Technique: Fixation of the ulnar neck fracture is performed after fixation of the distal radius fracture. Our technique uses anterograde intramedullary fixation to stabilize the fracture with a 1.6-mm (0.062 inch) Kirschner wire or a commercially available metacarpal fixation intramedullary nail. The fixation is introduced into the intramedullary space of the ulnar shaft 4 to 6 cm proximal to the fracture at a separate surgical site along the subcutaneous border of the ulna. The fixation is also supported with a sugar-tong splint for the first few weeks after surgery and requires removal of the ulnar implant approximately 10 weeks after implantation. Conclusion: Our technique utilizes a percutaneous approach with minimal fracture exposure. It provides a relatively simple and reproducible method to address ulnar neck fractures commonly seen in association with distal radial fractures.
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Naito, Kiyohito, Yoichi Sugiyama, Hiroyuki Obata, Atsuhiko Mogami, Osamu Obayashi, and Kazuo Kaneko. "Screw Fixation and Autogenous Bone Graft for an Irreducible Distal Ulna Fracture Associated with Distal Radius Fracture." Journal of Hand Surgery (Asian-Pacific Volume) 22, no. 02 (2017): 236–39. http://dx.doi.org/10.1142/s0218810417720145.
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Distal ulna fractures often occur with distal radius fractures, and their treatment method is still controversial. We considered reduction of the distal radio-ulnar joint (DRUJ) surface the most important factor when treating distal ulna fractures accompanied by residual dislocation. We herein presented a patient with a distal ulna fracture accompanied by dislocation of the DRUJ surface in whom an autogenous bone fragment collected from the radius was grafted onto the ulnar bone defect after open reduction and Herbert screw fixation. In this technique, the bone fragment was supported through the medullary cavity by inserting a Herbert screw, which was less likely to cause irritation between the screw and surrounding tissue, because the screw was almost entirely present in the bone. In addition, an autogenous bone graft from the same surgical field may be less invasive than that from another region.
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Reichler, I. M., P. M. Montavon, and B. Haas. "Use of the tubular external fixator in the treatment of distal radial and ulnar fractures in small dogs and cats." Veterinary and Comparative Orthopaedics and Traumatology 16, no. 03 (2003): 132–37. http://dx.doi.org/10.1055/s-0038-1632769.
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SummaryTwenty-two fractures of the distal radius and ulna in small dogs and cats treated with a tubular external fixator system were evaluated. Radius/ulna fractures in toy breeds often occur in the distal metaphyseal region. Placing two screws through a bone plate in the distal radius in such cases is difficult even if a miniplate is used. The tubular external fixator allows multiple-pin clamping in parallel with a single connecting bar. Using this technique, four pins can be placed in a bone fragment, the length of which would hold only two screws in a 2.0 mini-DCP. The tubular external fixator was found to be a satisfactory alternative to bone plating for the fixation of distal radial/ulnar fractures, providing sufficient fracture stability with minimal soft tissue trauma.
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Woods, Samantha, and Karen L. Perry. "Fractures of the radius and ulna." Companion Animal 22, no. 11 (2017): 670–80. http://dx.doi.org/10.12968/coan.2017.22.11.670.
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Pannu, Gurpal S., and Marty Herman. "Distal Radius-Ulna Fractures in Children." Orthopedic Clinics of North America 46, no. 2 (2015): 235–48. http://dx.doi.org/10.1016/j.ocl.2014.11.003.
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Rudd, Ray G., and Jon G. Whitehair. "Fractures of the Radius and Ulna." Veterinary Clinics of North America: Small Animal Practice 22, no. 1 (1992): 135–48. http://dx.doi.org/10.1016/s0195-5616(92)50009-2.
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Rauwelio, Alvin, I Made Dwi Pramana, Benny Supono, Ida Ayu Apsari Pradnya Niti, William Audi, and I Wayan Widana. "Supraclavicular Block Using Ultrasonography (USG) Guidance in Patients with Moderate Radius Ulna Fractures Mitral Regurgitation Undergoing ORIF (Open Reduction and Internal Fixation): A Case Report." Bioscientia Medicina : Journal of Biomedicine and Translational Research 8, no. 7 (2024): 4618–24. http://dx.doi.org/10.37275/bsm.v8i7.1032.
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Background: Open fractures of the radius and ulna in elderly patients are conditions that require fast and appropriate treatment. Open reduction internal fixation (ORIF) is a common treatment option, but in elderly patients, general anesthesia may be high risk. Supraclavicular brachial plexus block is an effective and safe regional anesthetic option for ORIF in elderly patients. Case presentation: We report the case of a 71-year-old man with an open fracture of the left third radius and middle ulna who was planned for ORIF. The patient had comorbid hypertension and reduced left ventricular function. Supraclavicular brachial plexus block was performed using 0.5% bupivacaine (10 mL) and 2% lidocaine (10 mL). The patient did not complain of pain during the operation and recovered well. Conclusion: Supraclavicular brachial plexus block is an effective and safe regional anesthetic option for ORIF in elderly patients with open fractures of the radius and ulna.
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Rahman, Khatib Shafiur, Mohammad Sultanul Arefin, and Md Nazmul Islam Nissan. "Evaluation of Fixation of Fracture Shaft of Radius Ulna without Tourniquet." Saudi Journal of Medical and Pharmaceutical Sciences 9, no. 05 (2023): 282–86. http://dx.doi.org/10.36348/sjmps.2023.v09i05.002.
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Background: Plate fixation is the mainstay of care for distal forearm shaft fractures in adults. By and large, volar or dorsal plating is used for radial shaft fractures. The radius's lateral surface offers an equal and constantly curved region for inserting a plate. The radial bow may be readily evaluated and restored after surgery. A prospective investigation was performed to examine the result of lateral plating of radius shaft fractures. Objective: In this study our main goal is to evaluate the treatment outcome of fixation of fracture shaft of radius ulna. Method: The research was conducted at tertiary medical hospital and district general hospital, Dinajpur included 100 patients. Several of them had broken both of their forearm bones, while others had broken only the radial shaft. Within 36 hours of damage, all patients were fixed with a 3.5 mm restricted contact dynamic compression plate or locking compression plate on the lateral surface of the radius. Typical procedure was used to repair the ulna. Results: During the study, majority were belong to 32-40 years age group, 36%. Followed by 20% were belong to 41-50 years age group, 11% belong to 20-31 years age group. In addition to that, 80% were male. 75% had fractured both of their forearm bones. Followed by 70% had closed fractured type, 35% had motor vehicle accident and lastly 85% had middle third radial shaft. Union was assessed by gradual disappearance of the fracture line and/or development of bridging callus at the fracture site. After getting treatment, 89% patients had excellent results, 8% had satisfactory and 1% had unsatisfactory result. There was 1% failure (nonunion). Conclusion: As compared to conventional methods, radial lateral plating holds promise as a viable option. Longitudinal studies with larger patient groups and study criteria are needed to confirm the potential advantages and validate our results.
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Movrin, Igor. "Hybrid fixation for repair of dual forearm fractures of adolescent patients: A case report and literature review." Acta Medico-Biotechnica 17, no. 1 (2024): 47–51. http://dx.doi.org/10.18690/actabiomed.267.
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Purpose: To assess hybrid fixation as an alternative option for repair of dual forearm fractures of adolescent patients. Case presentation: An 11-year-old boy presented with trauma to his right forearm resulting from playing on a trampoline. X-ray examinations confirmed fractures of both the right ulna and radius. Closed reduction and internal ESIN (elastic stable intramedullary nailing) fixation was selected for repair of the radius. Closed reduction of the ulnar fracture was unsuccessful, thus open reduction was performed. However, due to instability of the ulnar fracture after open reduction, internal plate fixation of the ulna was selected. At 3 months after surgery, the patient demonstrated full range of motion with no pain.
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Liang, Benjamin, Jen Ming Lai, Arul Murugan, Kin Ghee Chee, Sreedharan Sechachalam, and Tun-Lin Foo. "Proposed Guidelines for Treatment of Concomitant Distal Radius and Distal Ulna Fractures." Hand Surgery 20, no. 03 (2015): 396–401. http://dx.doi.org/10.1142/s0218810415500306.
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Background: Concomitant distal radius and distal ulna metaphysis or head fractures (DRUF) are uncommon and acceptable results have been reported from cast immobilisation and internal fixation. Methods: We reviewed the charts of 1094 patients treated for distal radius fracture at our institution in a two year period from 2009 to 2010. 24 patients with concomitant DRUF with were treated by cast immobilisation (group 1, n = 11), internal fixation of both bones (group 2, n = 7), internal fixation of radius alone (group 3, n = 2), and internal fixation of radius with distal ulna resection (group 4, n = 4). Patients treated by surgery underwent intraoperative assessment of distal ulna stability to determine the indication for ulna fixation. Post surgical range of motion, clinical parameters, and functional outcome scores (Gartland-Werley and modified Mayo) were measured. Results: Wrist motion was comparable in each group. Radiographic parameters were better in surgical groups. 23 of 24 patients achieved excellent/good outcomes based on Gartland-Werley scores, while 12 of 24 achieved good modified Mayo wrist score. There was a case of distal ulna non-union in group 1, and another case of delayed distal radius union in group 2. Conclusions: By evaluating patients’ functional requirement, and dynamic fluoroscopy examination, satisfactory outcomes can be achieved for various presentations of DRUF.
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Poroh, Manuela Gabi, Teodor Stefan Gheorghevici, and Bogdan Puha. "Peri-implant distal radius fracture due to car collision." Archive of Clinical Cases 10, no. 3 (2023): 114–18. http://dx.doi.org/10.22551/2023.40.1003.10254.
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Peri-implant fractures have gained increasing importance in orthopedics as the number of surgical procedures involving orthopedic implants rises globally. These fractures pose a significant challenge in terms of diagnosis, treatment, and postoperative management. They manifest as stress fractures distal to the implant site. Developing an effective treatment strategy involves evaluating multiple influencing factors. This article presents a rare case of a peri-implant distal radius fracture in a 63-year-old man, with no comorbidities, resulting from a car accident, classified as C1U in the Michele D’Arienzo system. The surgical intervention included plate fixation for the radius and wire fixation for the ulna. The wire was used for ulna instead of a plate, due to skin injuries, with good results. As life expectancy rises and individuals remain active in their elder years, the incidence of peri-implant fractures is expected to increase. Factors such as the implant type, surgeon's approach, and patient-specific elements may influence peri-implant fracture occurrence. The widespread use of plate fixation for distal radius fractures may also contribute to a parallel increase in such fractures. Providing detailed context and specific case presentation allows better understanding and implications for clinical practice.
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Plint, Amy C., Jeffrey J. Perry, and Jennifer L. Y. Tsang. "Pediatric wrist buckle fractures: Should we just splint and go?" CJEM 6, no. 06 (2004): 397–401. http://dx.doi.org/10.1017/s1481803500009386.
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ABSTRACT: Objectives: The objective of this study was to evaluate the utility of circumferential casting in the emergency department (ED), orthopedic follow-up visits, and radiographic follow-up in the management of children with wrist buckle fractures. Methods: We performed a retrospective medical record review of all children &lt; 18 years of age who presented to our tertiary care children’s hospital between July 1, 2000, and June 30, 2001, and were diagnosed with a fracture of the wrist, radius or ulna. Based on the radiology reports, we identified buckle fractures of the distal radius, the distal ulna, or both bones. We excluded children who had other types of fractures. Results: We identified 840 children with fractures of the wrist, radius, or ulna. Of these, 309 met our inclusion criteria. The median age of our study cohort was 9.2 years. Emergency physicians immobilized 269 of these fractures in circumferential casts; of these, 30 (11%) had cast complications. Of the 276 subjects who had orthopedic follow-up visits and radiographs, 184 (67%) had multiple visits and 127 (46%) had multiple radiographs performed. No subjects had fracture displacement identified on follow-up. Conclusions: Orthopedic follow-up visits and radiographic follow-up may have minimal utility in the treatment of pediatric wrist buckle fractures. ED casting may pose more risk than benefit for these children. Splinting in the ED with primary care follow-up appears to be a reasonable management strategy for these fractures. A prospective study comparing ED splinting and casting for pediatric wrist buckle fractures is needed.
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Chung, Lim Tin, Faris Indra Prahasta Didi Indra, and Mohd Anuar Ramdhan Ibrahim. "A RARE CASE OF TRIFOCAL RADIUS FRACTURE." Journal of Health and Translational Medicine 26, no. 2 (2023): 89–93. http://dx.doi.org/10.22452/jummec.vol26no2.10.
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Trifocal fracture of a radius is a rare injury. Trifocal factures involving the shaft of a radius were previously mentioned in a few literature. This type of fractures, involving proximal, shaft, and distal radius with ulna shaft fracture, has also been reported once. However, to the best of our knowledge, our report is the first describing trifocal injuries affecting the shaft and proximal and distal intraarticular part of the radius with an intact ulna shaft. Thorough clinical and radiological assessments are necessary for diagnosis as these injuries are commonly missed. We would like to share the presentation of this rare case and the importance of the correct management to achieve a good outcome.
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Boretto, Jorge G., Ezequiel E. Zaidenberg, Gerardo L. Gallucci, Alejandro Sarme, and Pablo De Carli. "Comparative Study of Internal Fixation of the Ulna and Distal Ulna Resection in Patients Older Than 70 Years With Distal Radius and Distal Metaphyseal Ulna Fractures." HAND 14, no. 4 (2018): 540–46. http://dx.doi.org/10.1177/1558944718760000.
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Background: Acute management of fractures of the distal ulna that are associated with fractures of the distal radius remains difficult, particularly in the elderly. Methods: In this study, we investigated whether internal fixation of the distal ulna is associated with a higher rate of complications than resection of the distal ulna in patients older than 70 years. Twenty-four consecutive patients were included in this study, 12 of whom had undergone open reduction and internal fixation (ORIF) of the distal ulna, and 12 who had undergone distal ulna resection. Patients were retrospectively assessed for range of motion, grip strength, pain, and radiographic appearance. The functional outcome was evaluated by the Mayo Wrist Score. Complications were classified according to the Classification of Surgical Complications. Results: There were no differences in patient demographics between the 2 groups, except patient age. Clinical evaluation showed no difference at follow-up; however, there were significantly more complications associated with ORIF compared with resection. Conclusions: The results from our study show that women older than 70 years with fracture of the distal radius and distal ulna have a higher rate of complications if ORIF of the distal ulna is performed. Patients should be warned, by surgeons, of this in cases where ORIF of the distal ulna is suggested.
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Damopolii, Christina A., Joudy Gessal, and Jonathan P. Suyono. "Medical Rehabilitation in Patient with Post ORIF et causa Neglected Epiphyseal Fracture Distal Radius-Ulna Sinistra: A Case Report." e-CliniC 11, no. 2 (2023): 233–42. http://dx.doi.org/10.35790/ecl.v11i2.44765.
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Distal radius-ulna fracture is one of the most common human osseous injuries, with incidence rate increasing worldwide. There are two peaks of prevalence: the first around the 10th and the second around the 60th year of life. During childhood, they are among the most common pediatric fractures accounting for 19.9 to 35.8% of all pediatric fractures. We reported a case of a boy 13 years old diagnosed as post open reduction internal fixation distal radius ulna et causa epiphyseal fracture. He came to rehabilitation outpatient clinic with chief complaint pain on his left forearm. He underwent a surgery two weeks ago at the distal radius ulna. The surgeon did osteotomy on ulna and then fixated with plate and screw. On physical examination, there were pain and range of motion limitation mainly on the forearm and wrist joint. The patient was treated with low level laser therapy at the surgical wound to promote healing and decrease edema, initial digital motion exercise along with active range of motion of the uninvolved joints. He was also educated about icing and medicamentation if pain still persisted. Once adequate bony healing had occurred, active, active-assisted, progressive passive wrist motion, and strengthening exercise using resistance were performed to maximize the result. At the end of rehabilitation program, there was great improvement on pain and also range of motion improvement. Albeit, there was still a slight range of motion limitation on ulnar deviation and wrist extension by 5 degrees. In conclusion, rehabilitation program is very beneficial in treating post-surgery patient using modalities and exercises to improve functional function. Keywords: epiphyseal fracture; radius-ulna; medical rehabilitation
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Mukesh, Kumar. "Determine the Relationship of the Subjective, Objective and Radiographic Method of Treatment: A Retrospective Study." International Journal of Toxicological and Pharmacological Research 13, no. 6 (2023): 317–21. https://doi.org/10.5281/zenodo.11201733.
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<strong>Aim and Objective:</strong> The aim of the study was to determine relationship of the subjective, objective and radiographic method of treatment. <strong>Material and Methods:</strong> A prospective study was conducted in the Department of orthopaedics for the period of 12 Months. Three methods of treatment were utilized: open reduction and internal fixation (ORIF), closed reduction and casting (CR), and external skeletal fixation with pins-in-plaster (PIP). The method of treatment was chosen by the attending surgeon based upon his experience and the type of injury. <strong>Results:</strong> Union occurred in 92 percent of radius fractures and 95 percent of ulna fractures, with an average time to union of 15.4 weeks for the radius and 16.8 weeks for the ulna. Union was more frequent after closed than after open fractures. This difference was most apparent in radius fractures where 13 percent of open fractures developed nonunions, compared to only 3 percent of closed injuries (p = 0.140). Also, the average time to union was 16 percent longer for open than for closed fractures of the radius (p = 0.022), and 35 percent longer for open fractures of the ulna (p = 0.010). Neither the frequency of nor the time to union varied significantly with the method of treatment. The amount of forearm rotation lost was directly proportional to the loss of normal alignment, reaching a mean of 39 degrees when the combined malalignment of the radius and ulna exceeded thirty degrees (p = 0.07). <strong>Conclusion:</strong> For this series of 120 adult patients, the end results following treatment of fractures of the shafts of the radius and ulna were good to excellent regardless of the method of treatment chosen. Except for a longer time to union and a higher infection rate, the outcomes of open and closed fractures were very similar. The presence of associated injuries was a strong predictor of a compromised end result.
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Shelton, Trevor J., J. Ryan Taylor, Lauren Agatstein, Andrea Bauer, and Brian Haus. "DISTAL ULNA PHYSEAL ARREST FOLLOWING DISTAL FOREARM FRACTURES IN CHILDREN." Orthopaedic Journal of Sports Medicine 7, no. 3_suppl (2019): 2325967119S0019. http://dx.doi.org/10.1177/2325967119s00190.
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Background: Pediatric forearm fractures are a common injury with only a small subset of these involving the distal physes of the radius and ulna. A common mechanism of injury in these fractures are from sports related injuries or fall on outstretch hand. Physeal fractures of the distal radius are well-studied, with varying rates of growth arrest and potential for deformity depending on the type of physeal fracture. The incidence and long-term complications of pediatric forearm fractures involving the distal ulna physis remains largely unknown. Distal ulnar physeal arrest can lead to the development of radioulnar length discrepancy and angular deformities. Two previous studies of limited sample size report a 50-55% of physeal arrest when the ulnar physiss was involved in the fractur, which seems higher than what is seen at our institution. The purpose of this study was to investigate the demographic distribution, as well as the incidence of physeal arrest following a physeal fracture of the distal ulna. Methods: After institutional review board approval, a retrospective study was performed of all patients with distal forearm fractures treated at our institution from January 2003 until December 2017. We included patients < 18 years of age who presented to our level-1 emergency department or to our orthopaedic department and excluded those with extra-physeal fracture and closed physis. Wrist x-rays of 1,618 patients with distal forearm fractures were reviewed revealing a total of 52 patients with distal ulna physeal fracture. Patient demographics including age, gender, height, weight, mechanism of injury, and age at follow up was recorded. Each injury x-ray was reviewed and the distal ulna physeal fracture was categorized using the Salter-Harris (SH) classification system. Concomitant injuries were also recorded and if there was a radial physeal injury the SH classification system was used again. All follow up radiographs > 6 months post-injury were reviewed to assess for physeal arrest. Results: There were a total of 11 patients (average age at injury 10 ± 2 years; 5 males, 6 females; average height 1.5 0.2 m, average weight 47 ± 23 kg) with at least 6 months follow up post injury (average follow up time 2.4 ± 2.2 years. Of these, the most common mechanism was fall on outstretch hand occurring 64% of the time (n = 7), followed by sports in 18% (1 football, 1 baseball), and 9% fall from bike (n = 1), and 9% from ATV accident (n = 1). The most frequent distal ulna physeal fracture was SH type 2 occurring 55% of the time (n = 6), while 36% had a SH type 3 (n = 4), and 9% had a SH type 1 (n = 1). Eight patients had an ipsilateral radius fracture with 45% having a metaphyseal fracture (n = 5) and 27% having a distal radius physeal fracture (n = 3; one SH type 1, and two SH type 2). One patient had an ipsilateral supracondylar fracture and another patient had a Galeazzi fracture. Casting was the most frequent treatment occurring 64% of the time (n = 7), followed by closed reduction and casting in 18% (n = 2). Closed reduction and percutaneous pinning was done in 9% (n = 1), and open reduction and internal fixation (ORIF) was done in 9% (n = 1). None of these patients developed distal ulna physeal arrest (while one of them developed a distal radius physeal arrest. The one patient with the Galezzi fracture did go on to develop a malunion with clicking of his wrist despite being treated with ORIF and required a revision osteotomy 7 months later. The remainder of patients had no complications. Conclusion/Significance: The most important finding of this study is that the rate of distal ulna physeal arrest following fracture was 0%. This is in contrast to previous studies of limited sample size that reported a rate of 50-55%. Our results demonstrate a much lower incidence of distal ulnar physeal arrest than previously thought in the pediatric population with distal forearm fractures. These findings suggest that the majority of patients with distal ulna physeal fractures do well with conservative management, and may only require routine clinical and radiographic follow up.
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Vatsya, Pulak, Anupam Gupta, Samarth Mittal, and Vivek Trikha. "Bone versus implant: an atypical presentation of a typical complication of forearm fractures." International Journal of Research in Orthopaedics 7, no. 4 (2021): 860. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20212437.
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<p class="abstract">Both bone forearm fractures are one of the most common upper limb fractures operated by orthopedicians. Although the primary surgery is usually relatively straight forward and simple, but we present a case where the primary surgery failed and the patient presented with a deformed hand after 5 months, even though there were signs of union on radiographs. When operated upon, although the ulna had undergone primary bone healing and a peri-implant fracture had occurred, whereas radius had refractured from the fracture site and the plate was bent giving the deformed appearance. We discuss this unique complication, the planning, difficulties and scope of errors in such a situation, where the race to union is won by ulna but lost by radius.</p>
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Avasthi, Adhish, and Chris Peach. "Fractures of the proximal radius and ulna." Orthopaedics and Trauma 33, no. 5 (2019): 322–29. http://dx.doi.org/10.1016/j.mporth.2019.07.008.
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Dr., A. Ajmera, S. Jain Dr., and M. Jain Dr. "Evaluation Of Cast Index In Predicting The Outcome Of Pediatric Forearm Fractures." Orthopaedic Journal of M P Chapter 26, no. 1 (2020): 30–33. https://doi.org/10.5281/zenodo.3969791.
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Background: Pediatric forearm fractures of radius ulna account for 40% of all pediatric fracture. Closed reduction followed by application of well molded plaster cast is the standard treatment for these fractures, which can be complicated by re-displacement inside the cast, which further needs re-manipulation or surgery. We assessed the rate if re-displacement in paediatric forearm fractures treated by cast by calculating the cast index. Material & Methods: 30 patients with fractures of both radius ulna were treated with close reduction and cast application and Cast Index was calculated in immediate post reduction and subsequent radiographs at 2, 4 and 6 weeks. These were evaluated for re-displacement and their relation with cast index. Results: The mean CI was found to be 0.858. Three patients had re-displacement which required re-manipulation, the mean CI in these re-displacement group was 0.92. Mean CI was found to be higher in proximal third fractures however it did not correspond to increased incidence of re-displacement. Conclusion: Our study provides sufficient association of cast index in predicting the outcome of pediatric forearm fractures. Higher CI in proximal third fracture didn’t correspond to increased incidence of re-displacement.
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Mukherjee, Soutrik, R. Parkaviyan, and Kallol Banerjee. "Monteggia Equivalent Variant Type 1 in an Adult, its Management and Functional Outcome with Literature Review." Journal of Orthopaedic Case Reports 14, no. 10 (2024): 163–68. http://dx.doi.org/10.13107/jocr.2024.v14.i10.4848.
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Introduction: In 1814, Giovanni Battista Monteggia first described the fracture pattern which was further characterized by Luis Bado in 1967. Bado also coined the term Monteggia equivalent which includes a spectrum of complex fracture patterns and dislocations of the proximal ulna and radius. Monteggia equivalent lesions in adults are rare with different injury mechanisms compared to children, and thus having different management procedures. Case Report: We report a Type 1 Monteggia equivalent variant in a 31-year-old female who presented with a proximal ulnar fracture along with an ipsilateral radial neck fracture extending into the radial head. A fracture pattern that has not been reported much in literature as per our observations and we suggest should be considered a Monteggia equivalent Type 1b. Osteosynthesis of the ulna and proximal radius was done and at 1-year follow-up, complete radiological union with near-native function was achieved. Conclusion: Early recognition of such complex fracture patterns and a reconstruction of the proximal radius wherever possible gives a better outcome than arthroplasty or excision as per literature. Keywords: Monteggia fractures, Monteggia equivalent, Monteggia variants in adults, radial neck fractures.
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Lutsky, Kevin, Ludovico Lucenti, and Pedro Beredjiklian. "Distal Ulna Fractures Associated With Operatively Treated Distal Radius Fracture." Journal of Hand Surgery 43, no. 9 (2018): S34. http://dx.doi.org/10.1016/j.jhsa.2018.06.075.
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Andreev, P., A. Skvortsov, R. Khabibyanov, and M. Maleev. "TECHNOLOGY FOR TREATMENT OF OLD FRACTURES AND DISLOCATIONS MONTEGIA." Sciences of Europe, no. 139 (April 26, 2024): 36–42. https://doi.org/10.5281/zenodo.11069722.
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Old Monteggia fracture-dislocation is characterized by a fracture of the upper third of the ulna with angular displacement of the fragments, dislocation of the head of the radius, rupture of the annular ligament, and a significant period, more than 2 weeks, from the moment of injury. Fragments of the ulna grow together, as a rule, at an angle, the apex of which is directed to the radial side. In this case, due to the angle of deformation, the ulna shortens relative to the radius, the interosseous space decreases, and the tension of the interosseous membrane weakens, due to which even the openly reduced head of the radius is not held in the joint. With a significant period of time since the injury, the growth of the radius, deprived of support in the humeroradial joint, becomes excessively intense, as a result of which the length of the radius becomes greater than the relative length of the radius on the healthy limb. These features of Monteggia fracture-dislocation in children determine a significant number of unsatisfactory surgical outcomes and the ineffectiveness of conservative methods of treatment.
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Johnson, A. L., J. P. Toombs, D. J. Schaeffer, and P. H. Laverty. "Simple and multiple fractures of the radius treated with an external fixator." Veterinary and Comparative Orthopaedics and Traumatology 15, no. 02 (2002): 97–103. http://dx.doi.org/10.1055/s-0038-1632721.
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SummaryThe medical records of 56 dogs with diaphyseal fractures of the radius and ulna treated with Type lb or Type II external skeletal fixation were reviewed. The patients were referred to the College of Veterinary Medicine University of Illinois or the Purdue University School of Veterinary Medicine during the period from 1983 to 1999. There were thirty-two “simple” fractures and twenty-four multiple fractures. Twenty-four Type II frames and eight Type lb frames were used to treat the “simple” fractures. Twenty Type II frames and four Type lb frames were used to treat the multiple fractures. Eight of the thirty-two dogs with “simple” fractures and twelve of the twenty-four dogs with multiple fractures were admitted with open fractures. Open fractures were associated with a significantly longer time to fracture “bridging” Open reduction was used more frequently for the treatment of dogs with “simple” fractures. Open reduction resulted in greater bone contact at the fracture site. Contact at the fracture site resulted in a shorter time to removal of the external fixation. Clinical union was achieved in fifty of fifty-six fractures, with a mean time to removal of the fixation of 14.2 weeks. Significant difference, in the mean time to fracture “bridging” or the mean time to fixator removal, were not found between the “simple” and multiple fracture groups. Complications occurred in 25% (14/56) of fractures. Complications of fracture healing occurred in 18% (9/56) of fracture repairs, and fracture related complications occurred in 9%. The complications occurred more frequently in dogs weighing under 5 kg. There was not any difference between the “simple” and multiple fracture groups, with respect to the type or frequency of complications experienced. The results of this study indicate that stabilization, with an External Fixator, is an appropriate treatment for both “simple” and multiple diaphyseal fractures of the radius and ulna.
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Cooley, S., J. J. Warnock, S. Nemanic, S. M. Stieger-Vanegas, and W. I. Baltzer. "Augmentation of diaphyseal fractures of the radius and ulna in toy breed dogs using a free autogenous omental graft and bone plating." Veterinary and Comparative Orthopaedics and Traumatology 28, no. 02 (2015): 131–39. http://dx.doi.org/10.3415/vcot-14-02-0020.
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SummaryObjectives: Evaluation of the short-term outcome, duration of bone healing, and complications following bone plate fixation in dogs weighing [uni2264]6 kg, with and without the use of a free autogenous greater omental graft (OG).Materials and methods: A retrospective clinical study reviewed the medical records of 25 dogs of body weight <6 kg with mid to distal diaphyseal fractures of the radius and ulna (29 fractures) treated with open reduction bone plate fixation. Thirteen out of 29 fractures were implanted with an additional 2–3 cm3 OG lateral, cranial, and medial to the fracture site, adjacent to the bone plate.Results: Median time to radiographic healing in OG fractures (n = 11) was 70 days (range 28–98) compared to 106 days (range: 56–144) in non-OG grafted fractures (n = 14). The OG dogs had no major complications; minor complications included oedema, erythema, and mild osteopenia. Six of the eight non-OG dogs for which follow-up could be obtained developed osteopenia necessitating implant removal, four of which re-fractured the radius one to five months after implant removal, with one dog re-fracturing the limb a second time and resulting in amputation. Telephone follow-up of owners of OG dogs (n = 11) three to 15 months (median 10) post-surgery did not identify any signs of lameness or other complications. Owners of the non-OG dogs (n = 8) reported that there were not any signs of lameness six to 48 months (median 36) post-surgery.Clinical relevance: Free autogenous omen-tal grafting of diaphyseal fractures of the radius and ulna was associated with radial and ulnar healing with minimal complications in dogs weighing less than 6 kg.
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Huang, Zhe-Kang, Wu Zeng, Jun Li, and Jun-Feng Zhu. "Distal radius fractures and distal ulna fractures among adults in a southern China county during the 11-year-period 2010 to 2020." Medicine 103, no. 41 (2024): e40109. http://dx.doi.org/10.1097/md.0000000000040109.
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Most distal radius fractures are associated with distal ulnar fractures. However, there is still a lack of consensus on the incidence of different types of distal ulnar fractures among adults in China. Therefore, we analyzed the incidence of distal radial fractures with and without associated distal ulnar fractures among adults in a southern China county from 2010 to 2020. Registry data of 2333 patients (2351 sides) with a distal radius fracture from 2010 to 2020 underwent evaluation, encompassing parameters such as age, sex, distal radius fracture classification, fracture side, and distal ulnar fracture classification. Distal radial fractures were classified according to the AO/OTA classification. Distal ulnar fractures were examined using the Q-modifier classification. 1719 females (73.68%) and 614 males (26.32%) were included in the study. Compared to men, the incidence of distal radial fractures accompanying distal ulnar fractures in women was approximately 2.8 times higher. Additionally, 49.81% of distal radius fractures were associated with fractures of the distal ulna, while 46.44% were associated with fractures of the ulnar styloid. The most common fracture type was that of the ulnar styloid Q1 (93.73%). The mean age of female patients was 61.71 ± 12.13, while male patients had an average age of 50.63 ± 14.86. The Q1 type was the most common type of distal ulnar fracture. We also found that more females (age range: 50 years or older) had type C distal radius fractures compared to males. However, type B fractures were observed more frequently in males than in females (range: 18–49 years). Osteoporosis was believed to be the main cause of fractures in women aged >50 years old. Moreover, the peak incidence of radius fractures in males was lower than in females in different age groups.
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Bedge, Vijayanand, Rakesh M. V., Darshan B., and Naveen M. Belaval. "A study of outcome of diaphyseal fractures of radius and ulna in paediatric age group treated with titanium elastic nailing system." International Journal of Research in Orthopaedics 10, no. 5 (2024): 1056–61. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20242404.
Full textAbstract:
A study of outcome of diaphyseal fractures of radius and ulna in paediatric age group treated with titanium elastic nailing system. The current study is an attempt to find out the functional outcome, radiological union, and complications of paediatric diaphyseal radius and ulna fracture treated with titanium elastic nail. This is a prospective study of twenty-five patients of age group 6 years to 16 years diagnosed with a diaphyseal fracture of radius and ulna treated with percutaneous nailing with titanium elastic nails in Department of Orthopaedics, S Nijalingappa Medical College and HSK Hospital, Bagalkot between November 2019 to April 2022. Clinical, functional and radiological outcomes were assessed with Anderson et al criteria for 6 months. In terms of union and range of motion using Anderson et al criteria 20 patients had excellent results, 2 patients had satisfactory results and one patient had an unsatisfactory result. There were no cases of poor results. Five cases had complications like Nail prominence, elbow stiffness, olecranon bursitis and super skin infection. The radiological union was achieved in a mean time of 8.24±2.62 weeks. Complications resolved after implant removal. Titanium elastic nail system showed excellent results in terms of bony union, functional outcome with minimal complications which resolve after nail exit. Therefore, titanium elastic nail system should be considered as an effective alternative of conservative management for forearm fractures in pediatric age group.
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Özkan, Sezai, Stefan Fischerauer, Thomas Kootstra, Femke Claessen, and David Ring. "Ulnar Neck Fractures Associated with Distal Radius Fractures." Journal of Wrist Surgery 07, no. 01 (2017): 071–76. http://dx.doi.org/10.1055/s-0037-1605382.
Full textAbstract:
Background There is little published data to guide management of ulnar neck fractures associated with fractures of the distal radius. Purpose As unplanned surgery usually reflects adverse events and this injury combination is relatively uncommon, we used a large database to study the incidence of unplanned surgeries after surgical and nonsurgical treatment of distal metaphyseal ulna fractures associated with a distal radius fracture and identify factors associated with these unplanned surgeries. Patients and Methods We identified 277 patients with an ulnar neck fracture associated with a distal radius fracture. Fifty-six (20%) ulnar neck fractures were initially treated operatively and six of them (11%) had a second, unplanned surgery. Of the 221 initially nonoperatively treated fractures, only one (0.45%) had a subsequent unplanned surgery that seemed unrelated to the fracture (ulnar nerve neurolysis). Results Bivariate analysis showed that younger age, open fracture, multifragmentary fractures, and initial operative treatment of the ulnar neck fracture were significantly associated with unplanned surgery. A multivariable analysis was not feasible due to the small number of unplanned surgeries. Conclusion Eighty percent of ulnar neck fractures associated with a fracture of the distal radius was treated nonoperatively in our region, and subsequent surgery for problems was very uncommon. Operative treatment and fracture complexity were associated with unplanned surgery, which reflected some measure of injury severity, technical inadequacy, and inherent problems associated with surgery. Level of Evidence Level II, prognostic study.
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Vishwas, S. Phadke, R. S. Kulkarni, and Jadhav Devendra. "Successful Conservative Management of Bayonet Fracture of the Lower End of Radius and Ulna in a 6-Year-Old Boy: A Case Report." International Journal Of Medical Case Reports 4, no. 4 (2023): 13–16. https://doi.org/10.5281/zenodo.8418491.
Full textAbstract:
Bayonet fractures of the lower end of both the radius and ulna in paediatric patients are exceedingly rare, posing unique challenges in their management and follow-up. In many of the instances these fractures are treated by open reduction and internal fixation under anaesthesia. However recent studies have claimed that these fractures in children can be immobilized without reduction in an overriding position with good outcome. Paediatric patients presenting with bayonet fractures needs prompt diagnosis, appropriate immobilization, and meticulous long-term monitoring. However neurovascular abnormalities must be ruled out in patients in whom conservative management is being contemplated. Compromised neurovascular status is an indication of urgent exploration, open reduction and internal fixation. We present here a case of 6 years old boy with bayonet fracture of lower end of radius and ulna who was conservatively managed by above elbow cast for 1 month. An X-ray taken 18 months after the removal of cast showed complete remodelling of the bones. This case report highlights the exceptional potential for bone remodelling and functional recovery in young patients when managed with conservative management strategy.
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Vezzoni, Luca, Paolo Abrescia, and Aldo Vezzoni. "Internal Radioulnar Fixation for Treatment of Nonunion of Proximal Radius and Ulna Fractures in a Toy Breed Dog." VCOT Open 04, no. 01 (2021): e24-e31. http://dx.doi.org/10.1055/s-0041-1723831.
Full textAbstract:
AbstractIn this case report, we describe an alternative surgical procedure to treat proximal radius and ulnar nonunion in a toy breed dog. A 14-month-old, Maltese cross-breed dog was referred after previous treatment with external and internal fixation had failed, resulting in a nonunion of a fracture of the proximal radius and ulna with the proximal radius fragment too small and friable to be used for fixation. A craniomedial approach was made to debride the radius nonunion site and a second approach to the lateral aspect of the ulna was made. The fracture was realigned and a titanium locking plate was applied in bridging fashion, fixed to the proximal ulnar fragment with three locking screws in the most proximal plate holes, a fourth screw was inserted in the mid-shaft of the distal ulnar fragment and three locking screws were inserted in the distal most holes of the plate through the distal ulna to engage the distal radial fragment. A recombinant bone morphogenetic protein 2 graft was inserted into the radius and ulna fracture sites. The dog had a successful clinical and radiographic outcome with bridging of the defect 4 weeks postoperatively and complete callus formation 8 weeks postoperatively. Implants have undergone dynamization and then removal. Use of a locking plate as an internal fixator achieving fixation of the proximal ulna and distal radius can be considered an option for the treatment of proximal radioulnar nonunions with a small proximal radial fragment.
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Deo, Amit, Navin Kumar Karn, and Roshani Bista. "Randomized Controlled trial Comparing Single Bone and Both Bone Fixation for Forearm Fracture in Children." International Research Journal of Multidisciplinary Scope 03, no. 03 (2022): 15–21. http://dx.doi.org/10.47857/irjms.2022.v03i03.079.
Full textAbstract:
Background: Fractures of shaft of the radius and ulna are one of the commonest injuries seen in the paediatric age group. Single bone intramedullary fixation has been advocated in the treatment of unstable diaphyseal forearm fractures. We conducted this study to evaluate the radiological and functional outcome in single bone and both bone fixation in forearm fracture in children. Methods: We designed a prospective randomized trial to compare single bone and both bone fixations in forearm fracture in aged 8-15 years. Fifty patients were presented to our institution during the period from May 2016 to May 2017 and randomly assigned a group with 25 patients in each group. Patients in Group A (SBF) were fixed with intramedullary Rush pin in ulna and those in Group B (DBF) were both radius and ulna were fixed. The patients were followed up for a period of twelve weeks. A radiological and functional outcome was evaluated and was compared and graded using Price et al. (1) criteria. Results: Among the 50 patients analyzed, randomization was successful. ROM of elbow at the final follow up was not statistically significant differences between two Groups. There were no statistically significant differences of radiological parameters at the final follow-up. Final assessment with Price et al. (1) criteria showed no statistically significant differences between two groups (P value- 0.1). Conclusion: Single bone ulna intramedullary fixation was comparable in terms of function and radiological parameter for both-bone forearm diaphyseal fracture in children.