Malunited Fracture of the Distal Ends of the Radius and the Ulna Corrected by Oblique Resection of the Distal End of the Ulna

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A FRACTURE that involves the distal ends of the radius and the ulna is one of the most common fractures that the general practitioner, the general surgeon, or the orthopedist is called upon to treat. If good function of the wrist joint is to be obtained, satisfactory reduction of the fracture must be accomplished. Good function of the traumatized wrist joint depends on four conditions: (1) restoration of normal length to the shortened radius, (2) correction of the dorsal angulation of the distal radial fragment, (3) relocation of the deviated distal radial or ulnar fragment, and (4) restoration of a normal, anatomic relationship between the radial-ulnar articulation. Failure to accomplish this last condition alone will cause progressive, traumatic changes that lead to loss of function of the wrist joint; and motion, particularly pronation and supination, may be severely limited.

The purpose of this paper is to: (1) illustrate, through a case presentation, the functional disability that may result at the wrist from a malunited fracture of the distal end of the ulna; (2) emphasize the value of distal ulnar resection to restore adequate function of the wrist joint, particularly pronation and supination; and (3) point out the value of making an oblique osteotomy resection of the distal end of the ulna in order to preserve the ulnar collateral ligament and thereby prevent instability of the wrist joint.

Report of a Case

A 39-year-old missionary nurse sustained a fracture of the distal end of the left radius and ulna in an automobile . . .



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