Distal radius fractures: using the ulna as an internal fixator: pilot study

• DOI: 10.1007/s12570-014-0268-9
• Publication Date: 2014-08-02T08:11:16Z
• Authors: Ahmed Naeem Atiyya; Ahmed Salem Eid; Timour El-Husseini
• Keywords: 0206 medical engineering; 02 engineering and technology

Various published studies indicate that the use of nonbridging fixators in distal radial fractures consistently yielded good functional and radiographic results. They maintain stable fixation without disturbing the biological milieu at the fracture site. Based on the concept of nonbridging external fixation, we introduced a new technique using the ulna as an internal fixator rod. Pins are inserted both proximal and distal to the fracture site and fixed to the ulna as well, thus utilizing it as an internal fixation rod. We hypothesize that using this technique will give favorable results regarding the functional and radiographic outcome in unstable distal radius fractures. Prospective study comprised of 20 consecutive patients (14 women, 6 men) with unstable fractures of the distal radius (with fairly large distal fragment for purchase). The patients were managed by the index technique. Twelve fractures were AO/A class and eight fractures were AO/C class according to the AO classification system. Clinical outcome measures were based on the rate of union, time to union, pain (visual analog score), grip strength, and range of motion as a percentage of the normal side. Radiographic outcome measures included volar tilt, radial inclination, radial length, and articular congruity. Follow up period averaged 11.5 months. All fractures united. The fixation construct maintained reduction well during healing with good radiological parameters at the final follow up. Clinical results paralleled the good radiological results. Pronation-supination range of motion was more affected than flexion-extension. No major complications occurred. At the short term follow up, nonbridging fixation using the ulna as an internal fixator for unstable fractures of the distal radius (with sufficient space for the placement of pins in the distal fragment) is a simple and minimally invasive technique. It reliably maintains the anatomy and yields good functional outcome. Therapeutic, level IV.