title: Contoured plating for proximal ulna nonunion: an improved technique.
abstract: Twenty-one patients having proximal ulna nonunion were treated with contoured plating. The most proximal hole received an intramedullary 6.5-mm cancellous lag screw that extends fixation of the nonunion site. Mean age of the patients was 41.7 years. Average follow-up period was 22 months. Union occurred in 19 cases after a mean of 9.6 weeks. Complications were persistent nonunion in two cases, a stiff elbow in one, hardware prominence in two, and a 1 x 1-cm ulcer over the curve of the plate in one case. The two unsatisfactory results were related to ulnohumeral arthritis. In conclusion, augmentation of the contoured plate with a 6.5-mm intramedullary cancellous lag screw creates a stable construct in treatment of proximal ulna nonunion. It applies axial compression, resists bending forces on the dorsal plate and allows early mobilization after surgery, regardless of the size of the proximal fragment.
authors.affiliation: Faculty of Medicine, Department of Orthopedics, Tanta University, Tanta, Egypt. aymkhalil41@hotmail.com
authors.forename: Ayman
authors.initials: A
authors.lastname: Khalil
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elsayed
authors.forename: Osama
authors.initials: O
authors.lastname: Seleem
mesh_terms: D000328:Adult; D001168:Arthritis / Q000000981:diagnostic imaging / Q000209:etiology; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000601:surgery*; D055815:Young Adult