Article
The incidence of distal ulna fractures by classification
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Authors
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Maria Moloney
- Department of Plastic Surgery, Hand Surgery and Burns, Linköping, Sweden
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Simon Farnebo
- Department of Plastic Surgery, Hand Surgery and Burns, Department of Clinical and Experimental Medicine, Linköping, Sweden
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Lars Adolfsson
- Department of Orthopaedics, Department of Clinical and Experimental Medicine, Linköping, Sweden
| Published: | February 6, 2020 |
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Outline
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Objectives/Interrogation: Distal ulna fractures can occur isolated, but often accompany a distal radius fracture. The aims of this study were to investigate the incidence of distal ulna fractures and by classification examine if any fracture types are more common than others. Further to investigate methods of treatment used.
Methods: Data were collected from all patients aged 18 years or older, treated for a fracture of the distal ulna in our region during 2010-2012. Patients were identified in the national registry of diagnose codes using the ICD 10 system, followed by screening of radiographs. The fractures were classified according to the AO comprehensive classification of fractures with a Q-modifier.
Results and Conclusions: The incidence of distal ulna fractures was 0.00074 per year based on the prevalence during 2010-2012. The most common fracture type was a fracture of the ulnar styloid (79 % Q1), followed by fractures of the ulnar neck (11 % Q2). The rarest fracture type was ulna head fractures (1 % Q4). Patients aged 65 years or older more commonly had a Q2 fracture (14%) or a Q3 fracture (6%). Younger patients, aged 18-34 years, were not found to have fractures of class Q3 or Q4 and only one patient had a Q5 fracture. The mean age at the time of injury was 63 years (SD 18), and 76 % of the patients were women. 92 % also had a fracture of the radius. A fall from standing height on an extended wrist was the cause of trauma in 79 % of the patients. 30 % of all the patients with Q2-Q6-fractures were treated operatively with internal fixation of the ulna fracture.
We found the incidence of the distal ulna fractures in adults to be 74/100,000 person-years. In comparison, the incidence of distal radius fractures has been reported to be more than three times higher. Most common is fractures of the ulnar styloid, followed by fractures of the ulnar neck. Fractures of class Q2-Q6 were most common in the population over 65 years, probably due to better bone quality in the younger and middle aged population. We found distal ulna fractures to be more common in females, and a high average age. This indicates that, just like distal radius fractures, distal ulna fractures can also at least partially be explained by the higher incidence of osteoporosis in postmenopausal women. Only a third of the ulna fractures were operated, indicating that most were considered either stable without internal fixation or stable after a concomitant radius fracture was internally fixed.
