FRACTURES OF THE DISTAL RADIUS AND ULNA

Associated fractures of the distal ulnar metaphysis were present in 19 of 320 distal radial fractures requiring either closed manipulation o r surgical treatment over a 2-year period, Four morphological patterns of ulnar fracture were encountered, the commonest being the type 1 si mple extra-articular fracture of the distal end of ulna with minimal c omminution (eight out of 19), 15 patients were treated conservatively and two each were treated by internal and external fixation. 15 patien ts were reviewed after a mean follow-up of 23.8 months and there were four excellent, five good, five fair clinical results and one poor res ult, Radiographically the distal radio-ulnar joint (DRUJ) was normal i n eight wrists, but longitudinal or horizontal disruption of the DRUJ was present in seven wrists, Fracture callus encroached on the DRUJ in three patients, who also had limitation of forearm rotation, Two comm inuted ulnar fractures (type 4) developed non-union, but both patients had full forearm rotation, in contrast to restriction of forearm rota tion in four out of five patients with type 1 fractures.