Fractures of the Proximal Ulna: A Spectrum of Injuries and Outcomes

Alexa R Deemer; Cody R Perskin; Connor P Littlefield; Jack Drake; Abhishek Ganta; Sanjit Konda; Kenneth A Egol

doi:10.1007/s43465-022-00793-3

Fractures of the Proximal Ulna: A Spectrum of Injuries and Outcomes

Indian J Orthop. 2022 Dec 23;57(2):262-268. doi: 10.1007/s43465-022-00793-3. eCollection 2023 Feb.

Authors

Alexa R Deemer¹, Cody R Perskin¹, Connor P Littlefield¹, Jack Drake¹, Abhishek Ganta^{1

2}, Sanjit Konda^{1

2}, Kenneth A Egol^{1

2}

Affiliations

¹ Department of Orthopedic Surgery, NYU Langone Medical Center, NYU Langone Orthopedic Hospital, NYU Langone Health, 301 E 17th Street, New York, NY 10003 USA.
² Department of Orthopedic Surgery, Jamaica Hospital Medical Center, New York, NY USA.

Abstract

Introduction: The purpose of this study is to assess the effect of radial head/ neck injury in association with proximal ulna fractures.

Methods: Between 2006 and 2020, 107 patients presented to our academic medical center for treatment of a proximal ulna fracture and were enrolled into an IRB-approved database. Radiographs, injury details, and surgical interventions were retrospectively reviewed. Patients were classified as having an isolated proximal ulna fracture (PU), a PU fracture with an associated radial head dislocation (M-D), or a Monteggia fracture with an associated radial head fracture (M-V). Clinical and functional outcomes were assessed at follow-up to determine what differences exist between fracture patterns. Statistics were generated using Chi-squared tests for categorical variables and one-way ANOVA tests for numerical variables.

Results: While all patients ultimately healed, time to radiographic healing in the PU cohort was shorter at 3.57 ± 1.7 months when compared to the M-V cohort (5.67 ± 3.8 months) (p < 0.05). At follow-up, patients in the M-V cohort had poorer elbow pronation and supination when compared to the PU and M-D cohorts (p < 0.05). Patients within the PU cohort had fewer complications than those in the M-D and M-V cohorts (p < 0.05). No differences were found between the three cohorts in regard to rates of reoperation, non-union, wound infection, and nerve compression (p > 0.05).

Conclusion: The Monteggia fracture with a concomitant radial head/neck fracture is a more disabling injury pattern when compared to an isolated proximal ulna fracture and Monteggia fracture without an associated radial head/neck fracture.

Keywords: Comparison; Monteggia fracture; Outcomes; Proximal Ulna fracture; Radial head fracture.

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