Executive Editor: Steve Krikler

Authors: Renato Fricker, Jesse Jupiter, Matej Kastelec

Distal forearm Extraarticular multifragmentary fracture of the ulna

back to skeleton

Glossary

General considerations

These are multifragmentary metaphyseal fractures of the ulna, involving neither the ulnocarpal nor distal radioulnar joints.

Nonoperative treatment - Cast
Main indication Skill Equipment
Unfit or low-demand patient Basic surgical experience, no specialized skills Basic equipment only

Indication

  • Stable DRU joint
  • Patient not fit for surgery
  • Poor state of soft tissues
  • Low-demand patient

Contraindication

  • Unstable DRU joint

Disadvantage

  • Increased risk of long-term mobility loss
ORIF - Bridge plate
Main indication Skill Equipment
All ulnar multifragmentary extraarticular fractures, where possible Highly experienced and skilled surgeon Simple surgical and imaging resources

Contraindications

  • Poor condition of overlying soft-tissue envelope
  • Patient not fit for surgery

Advantages

  • Early mobilization
  • Healing in anatomical position

Note: For multifragmentary fractures of the neck of the ulna, consideration may have to be given to the use of a mini condylar plate.

ORIF - Hook plate
Main indication Skill Equipment
All ulnar multifragmentary extraarticular fractures, where possible Highly experienced and skilled surgeon Simple surgical and imaging resources

Contraindications

  • Poor condition of overlying soft-tissue envelope
  • Patient not fit for surgery

Advantages

  • Better control of smaller distal fragments than with conventional plate
  • Early mobilization
  • Healing in anatomical position

Note: For multifragmentary fractures of the neck of the ulna, consideration may have to be given to the use of a mini condylar plate.

*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources