Primary excision of the ulnar head for fractures of the distal ulna associated with fractures of the distal radius in severe osteoporotic patients

Abstract

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.

Does Simultaneous Fixation of Both Distal Radius and Distal Ulnar Fractures Improve Outcomes? A Retrospective Cohort Study

“…Several surgical treatment methods have been reported for distal metaphyseal ulnar fractures accompanied by distal radius fractures, such as the conventional plate, 2 locking plate, 3 , 4 hook plate, 5 - 7 intramedullary device, 8 , 9 and primary resection. 10 Fixation of distal metaphyseal ulnar fractures can be challenging, 11 and several studies have shown the validity of conservative treatment alternatives. 12 - 17 If clinical outcomes of the conservative treatment for distal metaphyseal ulnar fractures accompanying distal radius fractures are the same when compared with those of surgical fixation, there is a possibility that unnecessary surgery can be avoided.…”

Ablation of Distal Ulna as an Index Procedure in A Complex Open Distal Radius-Ulna Fracture with Defective Soft Tissue Coverage

“…In a reported study no patients found their activities disturbed by reduced grip strength. Long term follow-up of almost 2 years in this series showed gradual improvement in the grip power [5]. With the accurate indication and diligent surgical workmanship, the classical Darrach distal ulna resection can be extended as an indispensable procedure when there is failure to achieve anatomic restoration of the ulna head to sigmoid notch articular relationship, compounded with unhealthy ulna bone and soft tissue scarcity.…”

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

“…More recently, Yoneda and Watanabe 25 reported the results of a case series of 23 patients aged over 70 years (mean 80 years) who underwent primary excision of the distal ulna with volar locking plate of the distal radius. Similar to our study, all fractures occurred in women.…”