Conservative Treatment of an Intra-Articular Shear Fracture of the Ulnar Head
26 May 2018
03 December 2018
10 January 2019 (online)
Background Isolated intra-articular fracture of the ulnar head is rare.
Case Description A 59-year-old woman experienced an ulnar head fracture involving the distal radioulnar joint after a fall at ground level. The intra-articular fragment of the ulnar head was rotated into anatomical alignment with an above-elbow cast in 90° of supination for 4 weeks. A below-elbow night splint was retained for 2 additional weeks. Twelve months post-injury, full active motion and bone union were achieved.
Literature Review Only three studies have reported treatment of isolated intra-articular ulnar head fractures, and in all cases open reduction and internal fixation were performed.
Clinical Relevance Our report demonstrated good results for the conservative treatment of an intra-articular ulnar head shear fracture, with early recovery of forearm rotation and wrist function.
- 1 May MM, Lawton JN, Blazar PE. Ulnar styloid fractures associated with distal radius fractures: incidence and implications for distal radioulnar joint instability. J Hand Surg Am 2002; 27 (06) 965-971
- 2 Ring D, McCarty LP, Campbell D, Jupiter JB. Condylar blade plate fixation of unstable fractures of the distal ulna associated with fracture of the distal radius. J Hand Surg Am 2004; 29 (01) 103-109
- 3 Jakab E, Ganos DL, Gagnon S. Isolated intra-articular fracture of the ulnar head. J Orthop Trauma 1993; 7 (03) 290-292
- 4 Solan MC, Rees R, Molloy S, Proctor MT. Internal fixation after intra-articular fracture of the distal ulna. J Bone Joint Surg Br 2003; 85 (02) 279-280
- 5 Goikoetxea X, Garmilla I, Etxebarria I, Careaga M. Isolated intra-articular fracture of the distal ulna: a rare injury related to airbag deployment. J Orthop Trauma 2006; 20 (04) 292-294
- 6 Hagert CG. The distal radioulnar joint in relation to the whole forearm. Clin Orthop Relat Res 1992; (275) 56-64
- 7 King GJ, McMurtry RY, Rubenstein JD, Gertzbein SD. Kinematics of the distal radioulnar joint. J Hand Surg Am 1986; 11 (06) 798-804
- 8 Cha SM, Shin HD, Kim KC, Park E. Treatment of unstable distal ulna fractures associated with distal radius fractures in patients 65 years and older. J Hand Surg Am 2012; 37 (12) 2481-2487
- 9 Dennison DG. Open reduction and internal locked fixation of unstable distal ulna fractures with concomitant distal radius fracture. J Hand Surg Am 2007; 32 (06) 801-805