Clinical course of treatment of proximal one third ulna fracture by plate osteosynthesis in skeletally mature individuals

Abstract

Objective: To study the clinical course including radiological union, fracture union time and functional outcome of plate osteosynthesis for proximal one third ulna fracture in skeletally mature individuals.Method: 30 patients of proximal ulna fractures who were treated by plate osteosynthesis were included in this study.Result: 30 patients were followed up for minimum duration of 6 months and the clinical outcomes were assessed according to the Mayo Elbow Performance Score (MEPS). Out of 30, our study included 21 olecranon fractures and 9 monteggia fractures. At final follow up of 6 month, our case series of olecranon fractures resulted mean MEPS of 89.3with 57.1% excellent results and 42.9 % good results, and all patients returning to pre-injury daily activities. For monteggia fractures, resulted mean MEPS score is 93.8 with 88.9% excellent result & 11.1 % good results. All fractures in our study had united by 6 months, both clinically and radiologically. Our study group had reported the complication of delayed union in 6 cases of olecranon fractures. No complications reported in treatment of monteggia fractures.Conclusion: Our study has yielded excellent results in respect of functional outcome, radiological and clinical union without any implant related complications in internal fixation of proximal one third ulna fracture including olecranon fractures and monteggia fractures with plate osteosynthesis. Monteggia fractures treated with plate osteosynthesis yielded slightly better outcome in respect of functional outcome, radiological and clinical union than olecranon fractures. Plate osteosynthesis can be done in comminuted along with non-comminuted proximal one third ulna fractures. We recommend plate osteosynthesis for proximal one third ulna fracture, because of its consistent results with respect to fracture union, stability across the fracture site and early mobilization for better functional results.