University Hospital for Orthopedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
Department for Hearing, Speech, and Voice Disorders, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Arch Orthop Trauma Surg. 2023 Jun;143(6):3137-3144. doi: 10.1007/s00402-022-04549-4. Epub 2022 Jul 18.
Given the absence of a satisfying plate system to deal with multifragmentary or subcapital distal ulnar fractures, the Distal Ulna Locking Plate (DUL, I.T.S. GmbH, Graz, Austria) could become a useful treatment option. This study aimed to evaluate the results of this anatomically pre-contoured plate regarding patients with unstable or displaced distal ulnar fractures.
In a prospective clinical trial, 20 patients (18 female, two male; mean age 70 years (24-91 years)) with unstable or displaced distal ulna fractures between December 2010 and August 2015 were analyzed. All patients were treated with open reduction and internal fixation using the DUL. They were evaluated at three follow-up appointments at 3, 6 and 12 months postoperatively regarding their bone healing, ulnar variance (UV), range of motion (ROM) and grip strength. Patient related outcomes were measured using the Disability of the Arm, Shoulder and Hand (DASH), the Patient Rated Wrist Evaluation (PRWE) questionnaires, and the Visual Analogue Scale (VAS). The results after one year were compared to the outcome of the healthy contralateral side.
All fractures treated with open reduction and internal fixation using the Distal Ulna Locking Plate healed within 6 months and showed stable ulnar variances after surgery. ROM (rotational plane 81.1 ± 9.0°, sagittal plane 55.1 ± 14.6°, frontal plane 33.0 ± 9.4°) and grip strength (18.7 ± 7.1 N) at the follow-up after 12 month had similar values compared with the uninjured side. The mean DASH score (36.4 ± 29.0), the PRWE-score (14.5 ± 27.0), and the VAS (at rest 0.5 ± 1.1, during activity 1.2 ± 2.4) after one year had no significant difference to the uninjured side. The surgeon's overall satisfaction rate regarding plate handling reached 81.8%.
Stabilization of unstable distal ulna fractures using the DUL restores nearly normal anatomy and function. Its pre-countered design, volar placement, and enhanced stability present a satisfying plate system.
The trial was retrospectively Registered at www.
gov on 16 December 2021 (Trial Registration Number: NCT05329012).
由于缺乏令人满意的接骨板系统来处理多片段或肱骨远端骨折，远端尺骨锁定板（DUL，I.T.S. GmbH，格拉茨，奥地利）可能成为一种有用的治疗选择。本研究旨在评估这种解剖预塑形板在不稳定或移位的远端尺骨骨折患者中的治疗效果。
在一项前瞻性临床试验中，分析了 2010 年 12 月至 2015 年 8 月期间，20 名（18 名女性，2 名男性；平均年龄 70 岁[24-91 岁]）不稳定或移位的远端尺骨骨折患者。所有患者均采用远端尺骨锁定板行切开复位内固定术。术后 3、6、12 个月对患者的骨愈合、尺骨差异（UV）、活动范围（ROM）和握力进行随访评估。采用手臂、肩部和手残疾（DASH）、患者腕部评估（PRWE）问卷和视觉模拟评分（VAS）评估患者相关结局。一年后的结果与健侧的结果进行比较。
所有采用远端尺骨锁定板切开复位内固定治疗的骨折均在 6 个月内愈合，术后尺骨差异稳定。术后 12 个月随访时，ROM（旋转平面 81.1±9.0°，矢状面 55.1±14.6°，额状面 33.0±9.4°）和握力（18.7±7.1 N）与健侧相似。一年后 DASH 评分（36.4±29.0）、PRWE 评分（14.5±27.0）和 VAS（静息时 0.5±1.1，活动时 1.2±2.4）与健侧无显著差异。医生对钢板处理的总体满意度达到 81.8%。
使用 DUL 稳定不稳定的远端尺骨骨折可恢复几乎正常的解剖和功能。其预成型设计、掌侧放置和增强的稳定性提供了一种令人满意的接骨板系统。
该试验于 2021 年 12 月 16 日在 www.clinicaltrials.gov 上进行了回顾性注册（试验注册号：NCT05329012）。
