The treatment of isolated fractures of the distal ulna.
The integrity of the periosteum and the interosseous membrane determine the stability of fractures of the distal ulna; this is indicated by the initial displacement. In fractures displaced by less than 50% the periosteum and interosseous membranes are largely intact; these fractures are stable and require only below-elbow immobilisation for protection and relief of pain. In fractures displaced by more than 50% the membranes are disrupted; these fractures are unstable and require above-elbow immobilisation for stability. As most fractures are displaced by less than 50%, immobilisation of the elbow, which significantly increases morbidity, is usually unnecessary. I report the results of a cadaveric study on the pathomechanics of fractures of the distal ulna, and of a prospective clinical trial in which the type of cast used for immobilisation was determined by the stability of the fracture.
D000203:Activities of Daily Living; D002370:Casts, Surgical; D004550:Elbow; D050723:Fractures, Bone / Q000628:therapy*; D005596:Fractures, Closed / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007103:Immobilization; D011446:Prospective Studies; D014458:Ulna Fractures / Q000473:pathology / Q000601:surgery / Q000628:therapy*