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 |  |
 |
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 |  |
 |
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 | |
|
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 |
 |
Some specialized surgical experience |
|
Highly experienced and skilled surgeon |
| *Equipment | |
|---|---|
|
Basic equipment only |
|
Simple surgical and imaging resources |
 |
Full specialized surgical and imaging resources |