11/20/2023 0 Comments Distal radius fracture classification![]() ĭistal Radioulnar Joint (DRUJ) Assessment of DRUJ stability is essential in determining if a distal ulna fracture requires surgical correction. These ligaments are primary stabilizers of the DRUJ. The ulnar styloid is also an attachment site for the TFCC, providing support and protection for the ulnar side of the wrist. Ulnar Styloid The ulnar styloid is a bony protrusion on the distal aspect of the ulnar head and is the attachment site for the superficial dorsal and palmar radioulnar ligaments. Ulna The ulna is the medially located forearm bone and narrows distally. The crucial anatomical parts of the distal ulna are the metaphysis, styloid, and head. Biomechanically the distal ulna acts as a stationary object for the radius to move around. This arrangement causes various load changes on the wrist depending on the grip and degree of pronation-supination. The ulnocarpal joint carries around 20% of the load capacity when in a neutral position. Support structures of the wrist, the triangular fibrocartilage complex (TFCC), and the distal radioulnar joint (DRUJ) are also commonly injured. ![]() Thus, proper treatment must be provided as the ulnar epiphyseal plate is responsible for up to 80% of the ulna growth. Isolated ulna fractures of the styloid and metaphysis are rare. Isolated ulnar physeal injuries are extremely uncommon and have a greater propensity for early growth plate arrest. However, two recent retrospective studies failed to demonstrate any specific correlation between distal ulnar shaft fractures and abuse in children. Other less common mechanisms involve extreme supination or pronation. Healthcare providers should always maintain a high index of suspicion for possible abuse with any upper extremity fracture presenting with an unclear mechanism of injury, as they have been tied to intimate partner violence. A nightstick fracture (isolated ulnar shaft fracture) is usually the result of a direct blow to the ulna while a person is attempting to shield themselves with their arms. Isolated fractures of the distal ulna occur without an accompanying radius injury. Distal ulnar metaphyseal fractures occur within 5 cm of the dome of the ulnar head-only 5% of distal radius fractures present with this associated injury. The least common presentation is an ulnar head fracture and is a sign of likely wrist instability. The ulna styloid is fractured more than any other part of the ulna and is found in 80% of intraarticular distal radius injuries. High energy mechanisms also increase the likelihood of a simultaneous distal ulna fracture. The opposite is true of younger patients who suffer intraarticular injuries from high-impact trauma. In advanced age individuals, the fracture pattern is usually extraarticular from low-energy causes. The predominant wrist position is dorsiflexion. It will cover key distal ulna fracture concepts, including epidemiology, pathophysiology, presentation, intervention, prognosis, and complications.īoth distal ulna and radius fractures are usually the result of a fall on an outstretched hand (FOOSH). (Xiao, 2021) This review aims to provide healthcare professionals from multiple disciplines with a better understanding of distal ulna fracture management. Poor understanding of this condition can lead to malunion, weakened grasp, and other serious complications. While most distal ulna injuries do not undergo surgery, there are situations where intervention is indicated. However, healthcare professionals must consider patient factors such as age, activity level, and expectations to maximize outcomes. Once the radius is stable, most distal ulna fractures heal well with conservative management alone. The appropriate treatment for a distal ulna fracture is typically surgical correction of the radius first. First responders, physicians, and support staff must understand how to manage them. The most common upper extremity fractures presenting to the emergency department are distal ulna and radius injuries.
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