M.E.Müller: Atlas: Fracture 22-A1

Radius/Ulna, Diaphysis,
simple fracture,
ulna, radius intact 0,58% of the total
4,50% of the radius/ulna
18,44% of the segment

147 fractures
46,7% group
71%M, 29%F

108 fractures
34,3% group
76%M, 24%F

60 fractures
19,0% group
58%M, 42%F

Oblique Transverse With dislocation radial head (Monteggia)

These are simple fractures of the diaphysis of the ulna, with the radius remaining intact. Ref. Manual of Internal Fixation:
232 - 251, 466 - 475.
Surgeon. RO, MS, RO.

At its diaphyseal level, the ulna has thick cortices, a narrow medullary cavity and a grossly triangular cross-section at its middle zone, where simple fractures with a transverse or an oblique fracture line can occur, quite difficult to reduce and hold by bloodless methods. Fractures without displacement can also occur, misinterpreted as hairline fractures and not strictly immobilized, evolving into delayed unions or pseudoarthrosis. This is the typical example to demonstrate that the motion of the fracture site, even if it is minimal, will cause resorption at the end of the fragments with progressive increase of the instability and thus disturbance of the healing process.

Internal fixation with a small plate will give quick and dependable results. The exposure of the ulna is quite simple by the postero-medial approach. It has a flat cortex, smoothly rounded distally, allowing the perfect

adaptation of a narrow straight DCPplate or of a one-third tubular plate. During the surgical procedure, all of the requisites for the internal fixation with a plate must be observed: anatomic reduction, interfragmentary compression whenever possible (oblique fractures), axial compression and fixation of a minimum of 6 cortices with the 3.5 mm screws. However, in the pure transverse fractures of the ulna and the radius, the interfragmentary lag screw is not essential provided that the plate is performing compression upon the reduced fracture. In other bones like the femur or the tibia, such a screw is essential.

Closed intramedullary nailing rarely attains perfect reductions, it always straightens the smooth curvatures of the ulna and it never allows early motion without external splints. Pseudoarthrosis is a frequent result of the cases treated by this method.

postoperative + 2 months

preoperative + 4 months

preoperative preoperative + 8 months + 8 months




						Radius/Ulna, Diaphysis, simple fracture, ulna, radius intact	0,58% of the total 4,50% of the radius/ulna 18,44% of the segment






These are simple fractures of the diaphysis of the ulna, with the radius remaining intact.		Ref. Manual of Internal Fixation: 232 - 251, 466 - 475. Surgeon. RO, MS, RO.

At its diaphyseal level, the ulna has thick cortices, a narrow medullary cavity and a grossly triangular cross-section at its middle zone, where simple fractures with a transverse or an oblique fracture line can occur, quite difficult to reduce and hold by bloodless methods. Fractures without displacement can also occur, misinterpreted as hairline fractures and not strictly immobilized, evolving into delayed unions or pseudoarthrosis. This is the typical example to demonstrate that the motion of the fracture site, even if it is minimal, will cause resorption at the end of the fragments with progressive increase of the instability and thus disturbance of the healing process. Internal fixation with a small plate will give quick and dependable results. The exposure of the ulna is quite simple by the postero-medial approach. It has a flat cortex, smoothly rounded distally, allowing the perfect	adaptation of a narrow straight DCPplate or of a one-third tubular plate. During the surgical procedure, all of the requisites for the internal fixation with a plate must be observed: anatomic reduction, interfragmentary compression whenever possible (oblique fractures), axial compression and fixation of a minimum of 6 cortices with the 3.5 mm screws. However, in the pure transverse fractures of the ulna and the radius, the interfragmentary lag screw is not essential provided that the plate is performing compression upon the reduced fracture. In other bones like the femur or the tibia, such a screw is essential. Closed intramedullary nailing rarely attains perfect reductions, it always straightens the smooth curvatures of the ulna and it never allows early motion without external splints. Pseudoarthrosis is a frequent result of the cases treated by this method.