title: Proposed Guidelines for Treatment of Concomitant Distal Radius and Distal Ulna Fractures.
abstract: BACKGROUND
  Concomitant distal radius and distal ulna metaphysis or head fractures (DRUF) are uncommon and acceptable results have been reported from cast immobilisation and internal fixation.
  
  
  METHODS
  We reviewed the charts of 1094 patients treated for distal radius fracture at our institution in a two year period from 2009 to 2010. 24 patients with concomitant DRUF with were treated by cast immobilisation (group 1, n = 11), internal fixation of both bones (group 2, n = 7), internal fixation of radius alone (group 3, n = 2), and internal fixation of radius with distal ulna resection (group 4, n = 4). Patients treated by surgery underwent intraoperative assessment of distal ulna stability to determine the indication for ulna fixation. Post surgical range of motion, clinical parameters, and functional outcome scores (Gartland-Werley and modified Mayo) were measured.
  
  
  RESULTS
  Wrist motion was comparable in each group. Radiographic parameters were better in surgical groups. 23 of 24 patients achieved excellent/good outcomes based on Gartland-Werley scores, while 12 of 24 achieved good modified Mayo wrist score. There was a case of distal ulna non-union in group 1, and another case of delayed distal radius union in group 2.
  
  
  CONCLUSIONS
  By evaluating patients' functional requirement, and dynamic fluoroscopy examination, satisfactory outcomes can be achieved for various presentations of DRUF.
authors.affiliation: ‡ Department of Hand & Reconstructive Microsurgery, Khoo Teck Puat Hospital, Singapore.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Liang
authors.affiliation: * Department of Hand & Reconstructive Microsurgery, Tan Tock Seng Hospital, Singapore.
authors.forename: Jen Ming
authors.initials: JM
authors.lastname: Lai
authors.affiliation: * Department of Hand & Reconstructive Microsurgery, Tan Tock Seng Hospital, Singapore.
authors.forename: Arul
authors.initials: A
authors.lastname: Murugan
authors.affiliation: * Department of Hand & Reconstructive Microsurgery, Tan Tock Seng Hospital, Singapore.
authors.forename: Kin Ghee
authors.initials: KG
authors.lastname: Chee
authors.affiliation: * Department of Hand & Reconstructive Microsurgery, Tan Tock Seng Hospital, Singapore.
authors.forename: Sreedharan
authors.initials: S
authors.lastname: Sechachalam
authors.affiliation: † Department of Hand & Reconstructive Microsurgery, National University Health System, Singapore.
authors.forename: Tun-Lin
authors.initials: TL
authors.lastname: Foo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002370:Casts, Surgical; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011885:Radius Fractures / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D014458:Ulna Fractures / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D014955:Wrist Joint
keywords: Distal radius fracture; Distal ulna fracture; Volar locking plate