Comparative Study of Internal Fixation of the Ulna and Distal Ulna Resection in Patients Older Than 70 Years With Distal Radius and Distal Metaphyseal Ulna Fractures

Hand (N Y). 2019 Jul;14(4):540-546. doi: 10.1177/1558944718760000. Epub 2018 Feb 20.

Abstract

Background: Acute management of fractures of the distal ulna that are associated with fractures of the distal radius remains difficult, particularly in the elderly. Methods: In this study, we investigated whether internal fixation of the distal ulna is associated with a higher rate of complications than resection of the distal ulna in patients older than 70 years. Twenty-four consecutive patients were included in this study, 12 of whom had undergone open reduction and internal fixation (ORIF) of the distal ulna, and 12 who had undergone distal ulna resection. Patients were retrospectively assessed for range of motion, grip strength, pain, and radiographic appearance. The functional outcome was evaluated by the Mayo Wrist Score. Complications were classified according to the Classification of Surgical Complications. Results: There were no differences in patient demographics between the 2 groups, except patient age. Clinical evaluation showed no difference at follow-up; however, there were significantly more complications associated with ORIF compared with resection. Conclusions: The results from our study show that women older than 70 years with fracture of the distal radius and distal ulna have a higher rate of complications if ORIF of the distal ulna is performed. Patients should be warned, by surgeons, of this in cases where ORIF of the distal ulna is suggested.

Keywords: complication; distal radius fracture; distal ulna and distal radius fractures; distal ulna fracture; distal ulna resection.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / adverse effects*
  • Fracture Fixation, Internal / methods
  • Humans
  • Male
  • Open Fracture Reduction / adverse effects*
  • Open Fracture Reduction / methods
  • Pain Measurement / statistics & numerical data
  • Postoperative Complications / epidemiology
  • Radiography / methods
  • Radius Fractures / diagnostic imaging
  • Radius Fractures / epidemiology
  • Radius Fractures / surgery*
  • Range of Motion, Articular / physiology
  • Retrospective Studies
  • Ulna / physiopathology
  • Ulna / surgery
  • Ulna Fractures / diagnostic imaging
  • Ulna Fractures / epidemiology
  • Ulna Fractures / surgery*