Treatment of minimal or nondisplaced distal two thirds isolated ulnar fractures: Above elbow cast or ORIF ?

Abstract

Objective: The optimal treatment for isolated fractures of ulnar shaft is debatable. The purpose of this study was to com- pare functional and radiological outcomes in patients treated for minimal or non-displaced distal two thirds isolated frac- tures of the ulnar shaft by open reduction and internal fixation and above elbow cast. Methods: A retrospective analysis was undertaken on patients diagnosed distal two thirds isolated ulnar shaft fracture between January 2012 and December 2020 with a minimum of six months follow-up. They were treated above elbow cast or open reduction internal fixation (ORIF) . Demographic information, clinical outcomes and complications were collected. Radiographs were reviewed to evaluate angulation, shortening, displacement and residual deformity. Results: 38 patients with a mean age of 44,3 years were treated by Iong arm cast (29/38) and ORIF (9/38). There was no difference between the groups for pain, range of motion at the elbow and wrist and union at the end of six months. Seven (23,6%) patients in the above elbow cast group and two (22,2%) in the ORIF group nonunited. Conclusion: Although there is no significant difference between the conservative and ORIF treatment in terms of results; ORIF may be more suitable for this fractures due to early mobilization and returning daily activiti