Distal ulnar fracture nonunion management: An uncommon case report

Abstract

A 47-year-old, right-hand dominant electrical worker was admitted to the emergency department of our hospital, after injury of the left wrist by a fallen metal bar at work. Clinical examination revealed swelling and tenderness at the left distal ulna. Distal neurovascular status was intact. Anteroposterior and lateral wrist radiographs demonstrated an isolated distal ulnar fracture with displacement ( Figure 1). Distal ulnar fracture nonunion management: An uncommon case report Chi Kin Lo and Wing Lok KamAbstract Introduction: Isolated distal ulnar fracture is an uncommon injury. Only a few case series that look into the management of ulnar fracture nonunion have been reported in the literature. Case presentation: A middle-aged manual worker presented to us for isolated fracture of his left distal ulna. He received open reduction and fixation of the distal ulnar fracture using distal ulna locking plate. It was complicated with nonunion and he complained of persistent wrist pain. This distal ulnar fracture nonunion was finally treated by SauveKapandji procedure with good functional outcome. Discussion: Displaced distal ulnar fracture should be reduced anatomically with rigid fixation to prevent disruption of the distal radioulnar joint. Fracture nonunion was traditionally managed with revision osteosynthesis and bone grafting. It is, however, technically difficult at the distal ulnar region because of the poor bone stock and lack of soft tissue coverage. Conclusion:We have demonstrated that the Sauvé-Kapandji procedure is a good treatment alternative for distal ulnar fracture nonunion.

Reduction of an Unusual Salter-Harris Type IV Fracture of the Ulna

“…However, these were mostly combined ulnar and radial fractures. Isolated fractures of the distal ulna are often a result of direct impacts to the ulna [11][12][13][14]. Nelson et al suggested that type III and IV fractures of the ulna are 3 Case Reports in Orthopedics rarely caused without either extreme ulnar deviation or displaced radial fractures [15].…”