Condylar blade plate fixation of unstable fractures of the distal ulna associated with fracture of the distal radius

Ring, David; McCarty, L. Pearce; Campbell, Douglas A.; Jupiter, Jesse B.

doi:10.1016/j.jhsa.2003.10.019

Cited by 69 publications

(94 citation statements)

References 19 publications

(17 reference statements)

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“…At latest follow-up, wrist-specific functional outcome was evaluated with the Gartland and Werley [8] wrist score as modified by Sarmiento [21]. Results are categorically defined within this demerit point system according to the total point range assigned to the injured wrist as excellent (0-2), good (3)(4)(5)(6)(7)(8), fair (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), and poor (≥21). Complications and secondary procedures were catalogued.…”

Section: Discussionmentioning

confidence: 99%

“…Concomitant distal radius and distal ulna metaphyseal/ articular fractures are uncommon injuries [1,5,10,20,22]. As these fractures typically involve the sigmoid notch and ulnar head/neck regions, obtaining anatomic reduction and re-establishing the articular congruity at the radiocarpal and distal radioulnar joints is recommended to ensure an Figure 2 Intraoperative anteroposterior (a) and lateral (b) radiographs following spanning distal radius external fixation, percutaneous Kirschner-wire fixation, and simultaneous distal ulna resection.…”

Section: Discussionmentioning

confidence: 99%

“…Operative Technique All 11 patients underwent acute primary distal ulna resection for irreparable, comminuted distal ulnar articular/metaphyseal fractures that remained displaced and unstable [5,20,23,25] following reduction and definitive fixation of the distal radius fracture. The distal ulnar resection was performed through a separate dorsal ulnar incision.…”

Section: Methodsmentioning

confidence: 99%

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Outcome following Acute Primary Distal Ulna Resection for Comminuted Distal Ulna Fractures at the Time of Operative Fixation of Unstable Fractures of the Distal Radius

Ruchelsman

Raskin

Rettig

2009

Hand (New York, N,Y.)

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Optimal acute management of the highly comminuted distal ulna head/neck fracture sustained in conjunction with an unstable distal radius fracture requiring operative fixation is not well established. The purpose of the present study was to determine the clinical, radiographic, and functional outcomes following acute primary distal ulna resection for comminuted distal ulna fractures performed in conjunction with the operative fixation of unstable distal radius fractures. Between 2000 and 2007, 11 consecutive patients, mean age 62 years (range, 30-75) were treated for concomitant closed, comminuted, unstable fractures of the distal radius and ulna metaphysis. All 11 patients underwent distal ulna resection through a separate dorsal ulnar incision with ECU tenodesis following surgical fixation of the distal radius fracture. According to the Q modifier of the Comprehensive Classification of Fractures, there were six comminuted fractures of the ulnar neck (Q3) and five fractures of the head/neck (Q5). Operative fixation of the distal radius fracture included volar plate fixation in four patients and spanning external fixation with supplemental percutaneous Kirschner wires in seven patients. At a mean of 42 months (range, 18-61 months) postoperatively, clinical, radiographic, and wrist-specific functional outcome with the modified Gartland and Werley wrist score were evaluated. At latest follow-up, mean wrist range of motion measured 53 degrees flexion (range, 35-60 degrees), 52 degrees extension (range, 30-60 degrees), 81 degrees pronation (range, 75-85 degrees), and 77 degrees supination (range, 70-85 degrees). Mean grip strength measured 90% of the contralateral, uninjured extremity (range, 50-133%). No patient had distal ulna instability. Final radiographic assessment demonstrated restoration of distal radius articular alignment. According to the system of Gartland and Werley as modified by Sarmiento, there were seven excellent and four good results. No patient has required a secondary surgical procedure. Acute primary distal ulna resection yields satisfactory clinical, radiographic, and functional results in appropriately selected patients and represents a reliable alternative to open reduction and internal fixation when anatomic restoration of the distal ulna/sigmoid notch cannot be achieved. Primary distal ulna resection with distal radius fracture fixation may help avoid secondary procedures related to distal ulna fixation or symptomatic post-traumatic distal radioulnar joint arthrosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Outcome following Acute Primary Distal Ulna Resection for Comminuted Distal Ulna Fractures at the Time of Operative Fixation of Unstable Fractures of the Distal Radius

Ruchelsman

Raskin

Rettig

2009

Hand (New York, N,Y.)

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“…1,2 Several fixation options have been described including condylar blade plate, locked 2.0-mm plates, and percutaneous pinning. 3,4 Difficulties with these techniques include prominence of hardware requiring removal, difficulty achieving fixation in osteoporotic bone, and morbidity associated with percutaneous pins. [3][4][5] Intrafocal pin plates are commercially available for minimally invasive fixation of distal radius fractures.…”

mentioning

confidence: 99%

“…3,4 Difficulties with these techniques include prominence of hardware requiring removal, difficulty achieving fixation in osteoporotic bone, and morbidity associated with percutaneous pins. [3][4][5] Intrafocal pin plates are commercially available for minimally invasive fixation of distal radius fractures. These devices combine a locking plate for fixation of the metaphysis distally with an intramedullary pin for proximal fixation within the shaft (Fig.…”

mentioning

confidence: 99%

Intrafocal Pin Plate Fixation of Distal Ulna Fractures Associated With Distal Radius Fractures

Foster

Bindra

2012

The Journal of Hand Surgery

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Fractures of the Distal Radius and Distal Radioulnar Joint

Campbell

Crawford

2014

Disorders of the Hand

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Condylar blade plate fixation of unstable fractures of the distal ulna associated with fracture of the distal radius

Cited by 69 publications

References 19 publications

Outcome following Acute Primary Distal Ulna Resection for Comminuted Distal Ulna Fractures at the Time of Operative Fixation of Unstable Fractures of the Distal Radius

Outcome following Acute Primary Distal Ulna Resection for Comminuted Distal Ulna Fractures at the Time of Operative Fixation of Unstable Fractures of the Distal Radius

Intrafocal Pin Plate Fixation of Distal Ulna Fractures Associated With Distal Radius Fractures

Fractures of the Distal Radius and Distal Radioulnar Joint

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