Surgical Treatment of Ulnar Metaphyseal Fracture Associated with Distal Radius Fracture in Osteoporotic Patients

ABSTRACT

PURPOSE: To evaluate the results of operative treatment for the unstable ulnar metaphyseal fractures associated with a distal radius fracture in osteoporotic patients. MATERIALS AND METHODS: Retrospective study was done on 10 patients with a ulnar metaphyseal fracture which was remained unstable after reduction and fixation of the distal radius fracture between March 2002 and Feb 2006. The average age was 72 years old. The mean follow up period was 25 months. Of 5 cases of Biayni type 1, 2, 3 fracture, 4 cases were treated with closed reduction and percutaneous pinning and one with open reduction and internal fixation with plate. All type 4 fractures were treated with ulnar resection. Range of motion, visual analogue scale for pain and grip strength were measured and clinical results were evaluated by Cooney's method. RESULTS: In ulnar fixation group, average motion was 68.5, 45.5, 65.3 and 75.8 degrees for flexion, extension, supination and pronation, respectively. The average grip strength was 102% of uninjured hand. In ulnar resection group, average motion was 65.5, 50.4, 75.2 and 75.5 degrees for flexion, extension, supination and pronation, respectively. The mean grip strength was 86.7% of uninjured hand. According to Cooney's method, there were excellent in one patient, good in seven, fair in one and poor in one. Fair and poor results were noted in case of AO type C fractures. CONCLUSION: Unstable ulnar metaphyseal fractures associated with distal radius fractures in osteoporotic patients can be treated successfully with ulnar fixation or resection. Ulnar resection is useful option in selected cases such as severe comminuted fractures.