• Soo-Min Cha, Hyun-Dae Shin, Kyung-Cheon Kim, and Eugene Park.
• Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Daejeon, Korea.
• J Hand Surg Am. 2012 Dec 1;37(12):2481-7.

PurposeTo prospectively compare the clinical and radiological outcomes of 2 treatment methods for unstable distal ulna fractures associated with distal radius fractures in patients 65 years of age and older.MethodsFrom February 2008 to March 2010, the first 29 ulnas were treated surgically (group 1) and the next 32 ulnas were treated nonoperatively (group 2). The mean final follow-up period was 34 months (range, 24-56 mo). All radiuses were fixed internally, in both groups. Clinical outcomes were compared between groups using a visual analog scale for postoperative pain; Disabilities of the Arm, Shoulder, and Hand scores; active range of motion; grip strength; and the modified system of Gartland and Werley. Radiological outcomes, including ulnar variance, were evaluated. Arthrosis was evaluated at the radiocarpal joint or distal radioulnar joint (DRUJ) according to the system of Knirk and Jupiter.ResultsThere were no significant differences between the groups in any of the clinical outcomes. No significant differences were observed for radiological outcomes including ulnar variance, distal radius, and union rate. There were no patients in either group with symptomatic arthritic changes in the radiocarpal joint or DRUJ at the final follow-up. In group 2, 1 patient had malunion (angulated, 14°) on the anteroposterior view without evidence of arthrosis in the DRUJ, and functional outcomes were good.ConclusionsIn this population distal ulna fractures can be successfully managed nonoperatively when they occur in combination with distal radius fractures.Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

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