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Related Concept Videos

Bones of the Upper Limb: Ulna01:15

Bones of the Upper Limb: Ulna

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The ulna and radius are parallel bones of the antebrachium or the forearm. The ulna lies medially and consists of a bony tip called the olecranon process at its proximal end. This hook-like projection articulates with the olecranon fossa of the humerus and forms the "hinged" ulnohumeral part of the elbow joint. This joint facilitates forearm extension and flexion while preventing its hyperextension. Similarly, the coronoid process, another bony projection on the proximal/anterior side...
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The upper limb consists of the arm, forearm, wrist, and hand bones. The humerus is the single bone of the upper arm region. Proximally, it has a large, spherical, smooth head that articulates with the glenoid cavity of the scapula to form the glenohumeral or shoulder joint. The margin of the head is the anatomical neck, a residual epiphyseal plate. Laterally it extends to form bony projections called the greater tubercle and the lesser tubercle. Next to the tubercles is the surgical neck, a...
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Related Experiment Video

Updated: Dec 18, 2025

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
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Do "Anatomic" Distal Ulna Plating Systems Fit the Distal Ulna Without Causing Soft Tissue Impingement?

Daniel A Shaerf1, Woo Jin Chae2, Reza Sharif-Razavian2

  • 1London North West University Healthcare NHS Trust, Middlesex, UK.

Hand (New York, N.Y.)
|June 11, 2020
PubMed
Summary

Distal ulna plates can irritate the extensor carpi ulnaris (ECU) tendon. The Acumed plate showed the least impingement, while Medartis required mandatory contouring for safe distal ulna fracture fixation.

Keywords:
anatomybasic sciencebiomechanicsdiagnosisextensor carpi ulnarisfracture/dislocationplatesafe zonespecialtysurgerytendonulnawrist

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Area of Science:

  • Orthopedic Surgery
  • Biomechanical Engineering
  • Anatomy

Background:

  • Distal ulna fracture fixation plates often lead to extensor carpi ulnaris (ECU) tendon irritation and necessitate removal.
  • The anatomical proximity of the ulna articular cartilage and the ECU tendon creates a narrow space, increasing impingement risk.

Purpose of the Study:

  • To define the safe zone for distal ulna plate application.
  • To determine if wrist and forearm positioning influences the risk of ECU tendon impingement.

Main Methods:

  • Four different distal ulna plates (Acumed, Medartis, Skeletal Dynamics, Synthes) were applied to 12 cadaveric specimens.
  • The safe zone was measured in terms of angular arc and circumferential distance.
  • Impingement was assessed across various wrist positions (flexion, extension, neutral, pronation, supination).

Main Results:

  • The safe zone for distal ulna plate placement is characterized by a 92° arc and a 15 mm perimeter.
  • Cumulative ECU impingement varied significantly by plate: Acumed (0%), Synthes (22%), Skeletal Dynamics (31%), and Medartis (68%).
  • Impingement was most frequently observed in the supination position, with a clear hierarchy of impingement risk: Medartis > Skeletal Dynamics > Synthes > Acumed.

Conclusions:

  • The mobility of the ECU tendon poses an impingement risk with ulnarly placed distal ulna plates.
  • Intra-operative assessment, particularly in supination, is crucial for evaluating plate impingement.
  • Plate-specific considerations include mandatory contouring for Medartis, Acumed's limitations in far-distal fractures, Synthes' suitability for proximal fractures, and Skeletal Dynamics' versatility.