Complete ulnar metaphyseal are uncommon fractures and tend to occur in children above 5 years of age.
The periosteum is either partially or totally disrupted and will influence the choice of treatment. In case of minor angulation, the periosteum opposite the apex will be intact, whereas the apex periosteum will be torn. The degree of angulation and the bone age of the child determine the tolerance for accepting residual malalignment.
If reduction fails to achieve an acceptable position, operative treatment may be indicated. In the first instance this is likely to be closed reduction under general anesthesia and percutaneous fixation with K-wires.
Open reduction might occasionally be necessary if there is marked displacement which cannot be reduced closed. Interposed soft tissues may prevent a successful closed reduction.