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Related Concept Videos

Bones of the Upper Limb: Ulna01:15

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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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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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The radius is longer of the two bones that make up the human antebrachium or forearm. At the proximal end, the radius articulates with the capitulum of the humerus and the radial notch of the ulna to form the elbow joint. At the distal end, the radius articulates with the ulna via the ulnar notch, forming the distal radioulnar joint. Distally, the radius also attaches to the carpal wrist bones (scaphoid and lunate) to form the radiocarpal joint.
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Distal Ulna Fracture Fixation with the Specialized Threaded Pin.

Michael J Niemann1, Andréa B Lese1, Shafic Sraj1

  • 1Department of Orthopaedics, West Virginia University, Morgantown, WV.

Journal of Hand Surgery Global Online
|July 31, 2023
PubMed
Summary

A novel threaded pin offers a viable intramedullary fixation for distal ulna fractures, avoiding hardware prominence common with plate fixation. This method shows promising outcomes for patients with associated distal radius fractures.

Keywords:
Distal ulnaFractureImplantIntramedullaryManagement

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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Biomedical Engineering

Background:

  • Distal ulna fractures often require surgical fixation due to malunion risks, especially when associated with distal radius fractures.
  • Traditional plate fixation for these fractures can lead to prominent hardware and necessitate removal.
  • Intramedullary fixation presents an alternative to mitigate complications associated with plate fixation.

Purpose of the Study:

  • To evaluate the efficacy of a novel intramedullary threaded pin for treating distal ulna fractures.
  • To assess patient outcomes and complications associated with this fixation method.
  • To compare this technique with traditional plate fixation for distal ulna fractures.

Main Methods:

  • A series of nine patients with distal ulna fractures, all with associated distal radius fractures, were treated using intramedullary threaded pin fixation.
  • Preoperative and postoperative radiographs were analyzed.
  • Patient-reported outcomes were assessed using the QuickDASH and visual analog scale (VAS) scores via phone follow-up.

Main Results:

  • The average QuickDASH score was 13.6, with a median of 9.1.
  • Three patients reported occasional ulnar-sided wrist pain (average VAS 1.3).
  • No threaded pin removal was required; one patient had radial plate removal. All patients returned to activities, except one who experienced stiffness affecting musical instrument playing.

Conclusions:

  • Intramedullary threaded pin fixation is a feasible alternative for distal ulna fractures.
  • This method may offer advantages over plate fixation by avoiding prominent hardware.
  • The technique demonstrates good patient outcomes with minimal need for secondary procedures.