Comparison of surgical treatments for distal ulna fracture when combined with anterior locking plate fixation of distal radius in the over 70 age group. (June 2023)

• Record Type: Journal Article
• Authors: Shibata, Ryutaro; Tokutake, Katsuhiro; Takegami, Yasuhiko; Natsume, Tadahiro; Matsubara, Yuji; Imagama, Shiro
• Is Part Of: Journal of hand surgery. Volume 48:Number 6(2023)
• Page Start: 516
• Page End: 523
• Publication Date: 2023-06
• Subjects: Darrach procedure -- Kirshner wire fixation -- locking plate fixation -- distal radius fracture -- distal ulna fracture -- elderly; 617.575059
• DOI: 10.1177/17531934221150495
• Languages: English
• ISSNs: 1753-1934

Abstract

We conducted a retrospective multicentre study to compare the clinical and radiographic outcomes, and complications of three surgical treatments of distal ulna fracture (DUF) when combined with anterior locking plate fixation for distal radial fracture (DRF) in patients over 70 years of age. We identified 1521 patients over 70 years of age who were diagnosed as having DRF and who underwent anterior locking plate fixation between 2015 and 2020, among which 122 cases of DUF were analysed. Three surgical treatment options for DUF were identified in this cohort: K-wire fixation (Group K), locking plate fixation (Group L) and Darrach procedure (Group D). The results of the analysis showed the total immobilization period in Group D to be the shortest among the three treatments. Functional outcomes were superior, and the rate of complications were smaller in Group D than in Group L. In addition, rotational range of motion was larger in Group D and Group L compared with Group K. In patients who are 70 years of age or older with combined unstable DRF and highly comminuted or displaced DUF, the Darrach procedure for DUF seems to be the most useful and reasonable treatment option once the fracture of the distal radius has been rigidly fixed. Level of evidence: IV.