Dataset Information

Periprosthetic fracture of the ulna-a case report.

ABSTRACT: After resection of the radial head, the load transmission through the forearm is changed dramatically. Most of the axial load is transmitted to the ulna. This can happen through the interosseous membrane, if intact, thus preventing proximal migration of theradius. However, radial head resection entails some slacking of the interosseous membrane, thereby reducing its ability to transmit load. In traumatic lesions of the interosseous membrane there is no limit to the proximal migration of the radius until the ulnar head abuts on the carpus. In both cases the load transmitted by the ulna increases dramatically and can promote fractures thereof. A 52-year-old, right-handed male patient presented with a periprosthetic fracture of the right ulna 6 weeks after implantation of an ulna head prosthesis. He had previously undergone radial head excision for malunion of the radial head and secondary humeroradial osteoarthritis. This operation had reduced pain and improved the range of motion at the elbow but entailed degenerative arthritis and related symptoms at the distal radioulnar joint (DRUJ). From the spectrum of possible treatment options, ulnar head resurfacing/hemiprosthesis was elected and performed without intraoperative or postoperative irregularities. However, 6 weeks postoperatively, as he was lifting a heavy object, a periprosthetic fracture of the ulna occurred, which ultimately was treated successfully by open reduction and plate fixation. Plate fixation of periprosthetic fractures is an established treatment concept after excluding implant loosening. Periprosthetic fracture of the ulna seems to be a rare complication but can be treated similarly.

SUBMITTER: Bauer D

PROVIDER: S-EPMC4408137 | biostudies-other | 2015 May

REPOSITORIES: biostudies-other

ACCESS DATA

Similar Datasets

Project description:IntroductionGiven the absence of a satisfying plate system to deal with multifragmentary or subcapital distal ulnar fractures, the Distal Ulna Locking Plate (DUL, I.T.S. GmbH, Graz, Austria) could become a useful treatment option. This study aimed to evaluate the results of this anatomically pre-contoured plate regarding patients with unstable or displaced distal ulnar fractures.MethodsIn a prospective clinical trial, 20 patients (18 female, two male; mean age 70 years (24-91 years)) with unstable or displaced distal ulna fractures between December 2010 and August 2015 were analyzed. All patients were treated with open reduction and internal fixation using the DUL. They were evaluated at three follow-up appointments at 3, 6 and 12 months postoperatively regarding their bone healing, ulnar variance (UV), range of motion (ROM) and grip strength. Patient related outcomes were measured using the Disability of the Arm, Shoulder and Hand (DASH), the Patient Rated Wrist Evaluation (PRWE) questionnaires, and the Visual Analogue Scale (VAS). The results after one year were compared to the outcome of the healthy contralateral side.ResultsAll fractures treated with open reduction and internal fixation using the Distal Ulna Locking Plate healed within 6 months and showed stable ulnar variances after surgery. ROM (rotational plane 81.1 ± 9.0°, sagittal plane 55.1 ± 14.6°, frontal plane 33.0 ± 9.4°) and grip strength (18.7 ± 7.1 N) at the follow-up after 12 month had similar values compared with the uninjured side. The mean DASH score (36.4 ± 29.0), the PRWE-score (14.5 ± 27.0), and the VAS (at rest 0.5 ± 1.1, during activity 1.2 ± 2.4) after one year had no significant difference to the uninjured side. The surgeon's overall satisfaction rate regarding plate handling reached 81.8%.ConclusionStabilization of unstable distal ulna fractures using the DUL restores nearly normal anatomy and function. Its pre-countered design, volar placement, and enhanced stability present a satisfying plate system.Trial registration The trial was retrospectively Registered at www.Clinicaltrialsgov on 16 December 2021 (Trial Registration Number: NCT05329012).

Dataset Information

Periprosthetic fracture of the ulna-a case report.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets