NONUNION OF DISTAL RADIAL FRACTURES ASSOCIATED WITH DISTAL ULNAR SHAFT FRACTURES - A REPORT OF 4 CASES

Although complications following distal radial fractures are common, n onunion is rare. We report four cases of radial nonunion following dis tal radial fractures that occurred in elderly women after low-energy f alls. The distinctive feature of these injuries was the presence of an associated distal ulnar shaft fracture. All patients had initial clos ed reduction and cast immobilization, which was unsuccessful. Reconstr uction was complicated by deformity, disuse osteoporosis, radiocarpal stiffness, and distal radioulnar joint disruption. Wrist arthrodesis i mproved function and decreased pain and deformity in three patients. M etaphyseal distal radial fractures associated with distal ulnar shaft fractures represent an unstable injury pattern, and closed reduction a nd casting may not be adequate treatment. Once established nonunion is present, wrist arthrodesis is a useful salvage procedure.