Executive Editor: Peter Trafton, Michael Baumgaertner

Authors: Peter Kloen, David Ring

Proximal forearm Ulna, extraarticular, multifragmentary

back to skeleton

Glossary

Proximal ulna metaphyseal fractures are usually part of a more complex injury with subluxation or dislocation of the proximal radioulnar joint.

Nonoperative
Indication summary Skill Equipment
Nondisplaced, stable fracture Basic surgical experience, no specialized skills Basic equipment only

Further indications

  • Infirm, less active patients that can function with less elbow extension strength (eg demented persons dependent on others for basic tasks such as bathing and eating)

Contraindications

  • Polytrauma

Advantages

  • Avoid medical and surgical risks

Disadvantages

  • Difficult to reconstruct later if unsatisfied with elbow extension strength
  • Risk of malunion
Temporary external fixation
Indication summary Skill Equipment
Significant soft-tissue injury or contamination Some specialized surgical experience Simple surgical and imaging resources

Further indications

  • Infection
  • Major bone loss
  • Polytraumatized patients (damage control)
  • Instability that cannot be controlled with splint or cast

Advantages

  • Quick procedure
  • Easy to perform
  • No additional damage to already injured tissue
  • Stabilizes the fracture for soft-tissue healing

Disadvantages

  • Temporary procedure
  • Pin-track complications
  • Iatrogenic nerve injury
Bridge plate
Indication summary Skill Equipment
Unstable, displaced fracture Highly experienced and skilled surgeon Simple surgical and imaging resources

Further indications

  • Instability of radiocapitellar or proximal radioulnar joint

Contraindications

  • Severe contamination or tissue loss

Advantages

  • Restoration of alignment
  • Ability to move and exercise the arm
*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

v2.0 2018-04-30