gms | German Medical Science

Objectives: The aim of the prospective study is to present indications and surgical technique and to assess early radiographic and functional results of plate osteosynthesis of distal ulna fractures using the LCP Distal Ulna Plate (De Puy Synthes, USA) with associated distal radius fractures treated by plate osteosynthesis.

Methods: Between August 2013 and September 2014 there were performed 18 plate osteosyntheses of distal ulna fractures with an associated distal radius fracture treated by plate osteosynthesis in patients in average age of 58 years (25-74). The indications of plate osteosynthesis of distal ulna included base fractures of the ulnar styloid process in 10 cases, comminuted displaced ulnar head fracture in 7 cases and subcapital ulnar head fracture in one case. The prospective follow-up lasted for an average of 9 months (3-12). The outcomes of surgery were evaluated on the basis of radiograms and multiplanar CT reconstructions, wrist function was assessed using Mayo Wrist Score and Quick DASH Questionnaire.

Results: The average wrist active range of motion was for flexion 68° (80-60), for extension 71° (90-40), for pronation 87° (90-70) and for supination 81° (90-50), representing 92 % (100-74) of ROM of the contralateral wrist. Postoperative radiograms and CTs demonstrated very good reduction of fractures of the distal radius and ulna. Within the postoperative observation we recorded full stability of the distal radioulnar joint in all patients, the final functional outcomes assessed using the Mayo Wrist Score were 84 points (100-55) and using the QuickDASH Questionnaire 7.4 points (0-47.7).

Discussion: Achieving nearly normal ROM of wrist and very good functional outcomes after clinical stabilization can be assessed as satisfactory. Functional results of treatment do correlate with the severity of fractures of the distal forearm.

Conclusion: From the results of early functional assessments and radiographic findings it can be concluded, that the internal fixation of distal ulna fractures with an associated distal radius fracture treated by ORIF is indicated in the case of displaced base fractures of the ulnar styloid process, the ulnar head fracture with dislocation of fragments causing incongruence of DRUJ and in the case of unstable and displaced subcapital ulnar fractures. Favorable early results of the study indicate a positive contribution of presented method of the distal ulna fractures plate osteosynthesis using the LCP Distal Ulna Plate.