Treatment of isolated ulnar shaft fractures with short arm cast

Year 2018, , 139 - 143, 06.06.2018

Mehmet Akdemir , Çağdaş Biçen , Ahmet Cemil Turan , Mehmet Aykut Türken Alper Arıkan , Ahmet Ekin

https://doi.org/10.17343/sdutfd.316269

Abstract

Objectives: isolated
ulnar shaft fractures are rare injuries but union problems are common.
Treatment with long arm cast and plate osteosynthesis has a potential risk
of  nonunion and delayed union. In this
study we aimed to discuss the radiological and clinical results of isolated
ulnar shaft fractures, treated with short arm cast.

Methods: 13 patients
treated with short arm cast in our clinic, were included to the study. Mean age
of patients was 44. The etiologies of fracture were direct blow for five, fall
for five and traffic accident for three patients. The radiographic evaluation
was made according to ulnar shaft anatomic angle, ulnar variance at the wrist
joint and presence of union. Clinical evaluation was made by Quick DASH  (Disabilities of Arm Shoulder and Hand) and
Visual Analog Scale.

Results: MEan follow-up
duration was 26.5 months. Among all patients 
union was achieved. Mean union duration was6.15 weeks.  Mean Q-DASH score was 2.97. mean ulnar shaft
anatomic angle was 1.8 degrees for at the time of fracture and 3.48 at the end
of the union. At the end of the treatment, one patient had neutral ulnar
variance , two positive and ten negative. Four patients had radiologic
malunion.

Conclusion:the
treatment results of short arm cast treatment of isolated ulnar shaft fractures
are good. Patients had some sort of malunion but it had little effect on
clinical results. Long arm cast should be used temporarily fort the treatment
of isolated ulnar shaft fractures, not till the end of the treatment. 

Keywords

Ulna, isolated shaft fracture, short arm cast, conservative treatment

İzole ulna şaft kırıklarının kısa kol sirküler alçı ile tedavisi

Abstract

Amaç: İzole ulna krıkları nadir görülen
kırıklardır ve kaynama gecikmesi nadir görülen bir durum değildir. Uzun kol
alçı ile plaklı tespitte kaynama gecikmesi ve yetersiz kaynama sorunları ile
karşılaşılabilmektedir. Biz bu çalışmamızda izole ulna kırığı olan ve kısa kol
alçı ile tedavi ettiğimiz hastalarımızın klinik ve radyolojik sonuçlarını
tartıştık.

Yöntem: kliniğimizde ulna diyafiz kırığı
nedeniyle konservatif  tedavi ettiğimiz
13 hasta çalışmaya dahil edildi. Hastaların yaş ortalaması 44'tü; 6 hasta
erkek, 7 hasta kadındı.  Hastalardan tümü
kısa kol sirküler alçı ile takip edildiler. Kırıkların 2'si proksimal 1/3, 7’si
orta, 4’ü distal yerleşimli izole ulna şaft kırığıydı. 5 hastada direkt darbe,
5 hastada düşme, 3 hastada ise araç içi trafik kazası sonucu kırık
oluşmuştu.  Hastaların radyolojik
değerlendirilmesinde ap  grafide ulna
şaftının eğilme açıları, el bileği seviyesinde ulnar  varyans ve kaynama durumuna bakıldı.
Hastaların klinik değerlendirilmesinde vizüel ağrı skalası, Q-DASH skorlamasına
bakıldı.

Bulgular: Hastaların
ortalama takip süresi 26.5 aydı. Tüm hastalarda kaynama elde edildi. Ortalama
kaynama süresi 6.15 haftaydı.  Ortalama
Q-DASH skoru 2.97 idi. Hastaların ap grafide ortalama ulna şaft açıları kırık
anında ortalama 1.8 derece, kaynama sonunda 3.48 dereceydi. Tedavi sonunda el
bilek ulnar varyans ortalama değeri 1 hastada nötral, 2 hastada pozitif, 10
hastada negatifti. 4 hastada radyolojik malunion saptanmıştı.

Sonuç: izole ulna şaft kırıkları kısa kol
alçı ile tedavisi sonuçları iyidir. Belirli düzeyde malunion görülse de klinik
üzerine etkisi yoktur. İzole ulna şaft kırıklarında uzun kol atel-alçı tespiti
geçici kullanılmalı, tedavinin tamamında kullanılmamalıdır. 

Keywords

Ulna, izole şaft kırığı, kısa kol alçı, konservatif tedavi

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