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At least 19 recordsLinked to original sources
PubMed2006

Ulna oblique osteotomy for radius and ulna length inequality: technique and applications.

An ulna that is too long or too short may be responsible for symptoms around the wrist. Several techniques are available to shorten or lengthen the ulna. We have used, among other techniques, an oblique osteotomy which allows the length of the ulna to be modified by sliding the 2 fragments over each other, taking care to keep good contact between them. The main advantage of this technique is that it combines length modification with a reorientation of the distal ulna, to restore congruency of the distal radioulnar joint. When shortening a long ulna, this may help to regain a normal range of pronation and supination. When used to lengthen a short ulna, it stabilizes the distal ulna stump, which may be a cause of pain if unstable and can impinge on the radius. This lengthening is combined with soft tissue procedures to further stabilize the distal stump.Our experience in using it for shortening was mainly in Madelung deformity and, for lengthening, the sequelae of too large a distal ulna resection.

Adult↗
PubMed1977

Asynchronous growth of the canine radius and ulna: effects of cross pinning the radius to the ulna.

Kirschner wires were introduced into the diaphyseal region of the radius and the ulna in 4 Australian shepherd crossbred pups, and change in relationships between the bones during growth was demonstrated. The contributions to longitudinal growth of the radius from proximal and distal growth plates were also calculated. Over the period of growth, the proximal growth plate contributed approximately 40% of the length of the radius. A marked shifting of the radius in relationship with the ulna occurred. This normal shifting between radius and ulna was prevented in 6 dogs by cross pinning the radius to the ulna at 90, 111, 142, and 168 days of age. Marked change was produced in the elbow joint, where altered relationships of articular surfaces of the radius and the ulna resulted in displacement of the humeral condyle from the trochlear notch of the ulna. Changes in dogs cross pinned at 90 and 111 days of age were most severe and consisted of severe degenerative changes which were most marked on the lateral side of the distal half of the trochlear notch of the ulna.

Aging↗
PubMed2000

Interventions for isolated diaphyseal fractures of the ulna in adults.

BACKGROUND: Isolated fractures of the shaft of the ulna, which are often sustained when the forearm is raised to shield against a blow, are generally treated on an out-patient basis. OBJECTIVES: To assess the effects of various forms of treatment for isolated fractures of the ulnar shaft in adults. SEARCH STRATEGY: We searched the Cochrane Musculoskeletal Injuries Group trials register, MEDLINE (1976 to August 1999), EMBASE (1981 to September 1999), the Cochrane Controlled Trials Register (up to Issue 4, 1999), and bibliographies of trial reports. Date of the most recent search: August 1999. SELECTION CRITERIA: Randomised or quasi-randomised trials of conservative and surgical treatment of isolated fractures of the ulnar shaft in adults. Excluded were fractures of the proximal ulna and Monteggia fracture dislocations. DATA COLLECTION AND ANALYSIS: Independent quality assessment and data extraction were performed by all reviewers. Requests for more information were sent to trialists. Given the limited and poor quality evidence available, quantitative analysis was kept to a minimum. MAIN RESULTS: Two small trials of conservative treatment, involving a total of 106 patients were included in this review. Both trials were of poor quality. One randomised trial compared short arm pre-fabricated functional braces with long arm plaster casts. There was no statistically significant difference in the time it took for fracture union. Patient satisfaction and return to work were better in the brace group. The other quasi-randomised trial compared Ace Wrap elastic bandage, short arm plaster cast and long arm plaster cast. The large loss to follow-up in this trial makes any data analysis tentative. However the need for replacement of the Ace wrap by other methods due to pain does indicate the potential for a serious problem with this intervention. REVIEWER'S CONCLUSIONS: There is insufficient evidence from randomised trials to determine which method of treatment is the most appropriate for isolated fractures of the ulnar shaft in adults. There is a need to establish the incidence of this injury and the outcome and associated costs of the various forms of treatment. Well designed randomised trials of current forms of conservative treatment are recommended.

Adult↗
PubMed1992

Wafer distal ulna resection for triangular fibrocartilage tears and/or ulna impaction syndrome.

Partial resection of the distal ulna (wafer resection) has been used to treat patients with symptomatic tears of the triangular fibrocartilage complex or mild ulna impaction syndrome. In this procedure, the distal 2 to 4 mm of the distal ulnar head is resected while preserving the ulnar styloid process and the ligaments attached to it. The triangular fibrocartilage is debrided, repaired, or partially excised as necessary. The procedure is contraindicated if there is more than 4 mm of positive ulnar variance. Thirteen wafer resections of the distal ulna were performed in 12 patients. All had good to excellent results after a minimum follow-up of 1 year. Wafer resection has specific advantages and avoids many of the potential complications of distal ulna recession and ulnar head resection for patients with the conditions described. The procedure is not indicated if instability or degenerative arthritis of the distal radioulnar joint is present or if there is carpal instability.

Adolescent↗
PubMed1994

Stabilisation of fractures of the proximal radius and ulna in a dog by application of a single plate to the ulna.

If a plating technique is used, fractures of the radius and ulna are usually stabilised by the application of a plate to the radius, or by the placement of plates on both the radius and ulna. This report describes the treatment of comminuted fractures of the proximal radius and ulna in a young dog by the application of a single plate to the caudal surface of the ulna. Satisfactory healing of both fractures occurred by five weeks after surgery. This approach avoided the difficult surgical approach to the proximal radius, and simplified the management of a dog with multiple fractures in one limb.

Animals↗
PubMed1998

[Ulna impaction syndrome therapy: decompressive surgical procedures of the head of the ulna].

The ulnar impaction syndrome can be defined as the impaction of the ulnar head against the triangular fibrocartilage complex and ulnar carpus. As a result of this pattern, painful degeneration of the TFCC occurs. Wrist arthroscopy offers a certain diagnostic tool. In addition, arthroscopic debridement of the TFCC shows a high success rate of 70 to 80 percent. After failed arthroscopic debridement, ulnar shortening osteotomy reduces ulnar load significantly. Malunion of the radius resulting in posttraumatic ulna-plus variance should be treated by correction osteotomy with lengthening of the radius. If arthrosis of the distal radioulnar joint is combined with ulnar impaction syndrome, the hemiresection procedure of Bowers or the method of Kapandji-Sauvé are the methods of choice.

Arthroscopy↗
PubMed1991

Comparative increases of lead and barium with age in human tooth enamel, rib and ulna.

Lead and Ba in postmortem tooth enamel, rib and ulna of six contemporary people (67-96 years; ave. 80) were shown to exhibit similar accumulations with age in the three different types of osseous tissue: Pb/Ca (wt) = 3.0, 5.2, and 3.9 x 10(-5) in rib, ulna, and tooth enamel; and Ba/Ca (wt) = 2.4, 2.4, and 1.8 x 10(-5) in rib, ulna, and tooth enamel, respectively. Mean concentrations of Pb were 11, 19, and 14 micrograms g-1 in rib (ash), ulna (ash), and enamel (dry), respectively. Means for Ba were 8.7, 8.9, and 6.4 micrograms g-1 in rib (ash), ulna (ash), and enamel (dry), respectively. Comparison of Ba in ulna of our 80-year-old subjects with Ba determined by other investigators in bones of younger contemporary populations indicated that Ba accumulates with age at about half the rate of Pb accumulation in bone. Concentrations of Ba in rib, ulna and enamel were positively correlated and similar within an individual, but varied among subjects in proportion to variations in absorptive uptake in portal blood. Barium may diffuse from a blood-dentine source into enamel, where it replaces Ca and accumulates with age. Because of extreme Pb pollution of our 80-year-old subjects and its variation of intake with age, the correlation of Pb in tooth enamel with Pb in bone was more scattered than for Ba. It is shown by means of stable Pb isotopic tracers that: (i) among the three types of osseous tissue, the residence time of Pb is longest in enamel, where it apparently accumulates with age by diffusion with little loss through exchange; and (ii) the residence time of Pb is longer in compact ulna than in trabecular rib, as it accompanies Ca in its osteoblastic transfer from blood to bone and then in its osteoclastic transfer back to blood from bone.

Aged↗
PubMed1998

Vascular anatomy of the ulna.

The vascular anatomy of the ulna was studied. Ten fresh-frozen upper extremity specimens were injected with India ink and latex solution. The extraosseous anatomy was dissected. The intraosseous anatomy was evaluated after treatment with the modified Spalteholtz technique. The proximal periarticular portion of the ulna was supplied by numerous, very small periarticular branches running in the capsule. A major intramedullary nutrient vessel arose from the ulnar artery or ulnar recurrent artery in all specimens and entered at the base of the coronoid. The ulnar artery gave off a common interosseous artery that branches into posterior and anterior interosseous vessels that course distally on the interosseous membrane. The interosseous vessels were critical for they supply the only observed vascular branches to the ulna diaphysis. The anterior interosseous vessel supplied on average 7 branches (range, 3-11 branches) to the ulna diaphysis spaced at generally regular 2-cm intervals, with the number of branches decreasing in the distal third. The posterior interosseous artery supplied an average of 11 branches (range, 9-14 branches) to the ulna diaphysis spaced at 1-cm intervals. The distal ulna metaphysis was supplied by terminal branches of the anterior interosseous artery. The ulnar head was supplied by small branches off the ulnar artery proper. In summary, the blood supply to the ulna diaphysis was dependent on segmental vessels provided by the anterior and posterior interosseous vessels. No dominant intramedullary vessel was observed in the diaphysis. The interosseous vessels should be protected when treating a ulna fracture or a nonunion, or when performing an osteotomy.

Cadaver↗
PubMed2002

Changes in strain distribution along the radius and ulna with loading and interosseous membrane section.

The changes in strain distribution along the radius and ulna with loading and interosseous membrane (IOM) section were analyzed in this biomechanical study. Four cadaveric upper extremities were dissected and strain gauges applied. The forearm was loaded at the distal radius with a carpal implant after being positioned upright in neutral forearm rotation. Strain measurements were recorded before and after transection of the IOM. Before IOM transection, increased compressive strain was measured on the ulnar border of the ulna, while increased tensile strain was recorded on the dorsal aspect of the ulna, the dorsal aspect of the radius, and the lateral border of the radius when compared with the unloaded forearm. This suggests bowing of the radius and ulna with the convex side dorsally and bowing of the radius with the convex side radially. After IOM transection, increased tensile strain on the lateral border of the radius and the ulnar border of the ulna was measured when compared with the loaded forearm with an intact IOM. No change in strain patterns was measured by the strain gauges located on the dorsal aspect of the radius or ulna after IOM transection. The increased tensile strain during constant load application suggests increased bending moments acting on the radius and ulna after IOM transection.

Compressive Strength↗
PubMed2003

Wide excision of the distal ulna: biomechanical testing of a salvage procedure.

PURPOSE: To study changes in the relationship of the distal radius and ulna after progressive resection of the distal ulna. METHOD: Six-degree-of-freedom motion sensors were used to determine relative motion and a displacement transducer was used to determine strain changes in the interosseous membrane (IOM). These were applied in cadaveric specimens loaded to simulate wrist motion and axial compressive forces. RESULTS: Strain in the IOM decreased with increasing resection of the distal ulna. The distance between the radius and ulna decreased with increasing resection up to 20% of ulna length. CONCLUSIONS: The decreased strain in the IOM and stabilization of the distance between the radius and ulna at 20% resection level provides biomechanical support for the satisfactory clinical results seen after wide ulnar resection. Wide excision of the distal ulna may be a viable salvage alternative to creation of a one-bone forearm.

Biomechanical Phenomena↗
PubMed2002

The effect of rotational malunion of the radius and the ulna on supination and pronation.

We have assessed the influence of isolated and combined rotational malunion of the radius and ulna on the rotation of the forearm. Osteotomies were made in both the radius and the ulna at the mid-diaphyseal level of five cadaver forearms and stabilised with intramedullary metal implants. Malunion about the axis of the respective forearm bone was produced at intervals of 10 degrees. The ranges of pronation and supination were recorded by a potentiometer under computer control. We examined rotational malunions of 10 degrees to 80 degrees of either the radius or ulna alone and combined rotational malunions of 20 degrees to 60 degrees of both the radius and ulna. Malunion of the ulna in supination had little effect on rotation of the forearm. Malunion of either the radius or of the ulna in pronation gave a moderate reduction of rotation of the forearm. By contrast, malunion of the radius in supination markedly reduced rotation of the forearm, especially with malunion greater than 60 degrees. Combined rotational malunion produced contrasting results. A combination of rotational malunion of the radius and ulna in the same direction had an effect similar to that of an isolated malunion of the radius. A combination in the opposite direction gave the largest limitation of the range of movement. Clinically, rotational malunion may be isolated or part of a complex angular/rotational deformity and rotational malunion may lead to marked impairment of rotation of the forearm. A reproducible method for assessing rotational malunion is therefore needed.

Cadaver↗