Cen Chaode, He Daqing, Cao Aixin, Xie Yuehua, Hu Chaoran, Cao Yongfei
Department of Orthopedics, Beijing Jishuitan Hospital Guizhou Hospital, Guiyang, 550014, China.
Department of Orthopedics, People's Hospital of Weining Yi, Hui and Miao Autonomous County, Bijie, 553100, China.
J Orthop Surg Res. 2025 Mar 12;20(1):267. doi: 10.1186/s13018-025-05646-x.
Distal ulna fractures often occur in conjunction with distal radius fractures and other associated injuries. Currently, there are no satisfactory internal fixation systems available for addressing unstable distal ulna fractures, and a definitive consensus on the most effective treatment approach is still lacking. The objective of this research was to evaluate the clinical outcomes of using elastic stable intramedullary nails (ESIN) compared to locking compression plates (LCP) for treating unstable distal ulnar fractures in adults.
In a prospective clinical study, a total of 54 patients (21 females and 33 males; average age 49.3 years, ranging from 30 to 63 years) suffering from unstable or displaced fractures of the distal ulna were randomly allocated to one of two treatment groups between January 2021 and August 2024. Specifically, 26 patients underwent treatment utilizing elastic stable intramedullary nails, whereas 28 patients were managed using locking compression plates. The two groups were evaluated prospectively for perioperative data and functional results.
The ESIN group comprised 26 patients, exhibiting a mean age of 48.27 years (with a range of 30 to 62 years), while the LCP group included 28 patients, whose mean age was 50.33 years (ranging from 32 to 63 years). Both groups were comparable regarding gender distribution, side of injury, mechanisms of injury, and classifications of fractures. However, there were significant differences noted in incision length of the ulna, surgical duration, frequency of fluoroscopy, and the rates of excellent and good functional outcomes as measured by the Gartland-Werley scores between the two groups (P < 0.05). Conversely, no significant differences were found concerning the time to union and the duration of immobilization between the two groups (P > 0.05).
ESIN offers several advantages, including reduced incision length, lower frequency of fluoroscopy, shorter duration of the surgical procedure, decreased complication rates, and improved Gartland-Werly scores. Therefore, fixation using ESIN serves as an effective alternative for the treatment of distal ulnar fractures in adults. The minimally invasive nature and lower complication rates are defining characteristics of ESIN fixation.
尺骨远端骨折常与桡骨远端骨折及其他相关损伤同时发生。目前，尚无令人满意的内固定系统可用于治疗不稳定的尺骨远端骨折，对于最有效的治疗方法仍未达成明确共识。本研究的目的是评估与锁定加压钢板（LCP）相比，使用弹性稳定髓内钉（ESIN）治疗成人不稳定尺骨远端骨折的临床疗效。
在一项前瞻性临床研究中，2021年1月至2024年8月期间，共有54例（21例女性和33例男性；平均年龄49.3岁，年龄范围30至63岁）尺骨远端不稳定或移位骨折患者被随机分配至两个治疗组之一。具体而言，26例患者采用弹性稳定髓内钉进行治疗，而28例患者采用锁定加压钢板进行治疗。对两组患者的围手术期数据和功能结果进行前瞻性评估。
ESIN组有26例患者，平均年龄48.27岁（年龄范围30至62岁），而LCP组有28例患者，平均年龄50.33岁（年龄范围32至63岁）。两组在性别分布、受伤侧、损伤机制和骨折分类方面具有可比性。然而，两组之间在尺骨切口长度、手术时间、透视频率以及根据Gartland-Werley评分衡量的优良功能结果率方面存在显著差异（P < 0.05）。相反，两组之间在骨折愈合时间和固定时间方面未发现显著差异（P > 0.05）。
ESIN具有多种优势，包括切口长度缩短、透视频率降低、手术时间缩短、并发症发生率降低以及Gartland-Werly评分改善。因此，使用ESIN固定是治疗成人尺骨远端骨折的有效替代方法。ESIN固定的微创性质和较低并发症发生率是其显著特点。
