Treatment of Distal Ulnar Fractures

Initial Assessment and Classification

• Fractures with >3mm displacement or >10° angulation are considered significantly displaced, according to the American Academy of Orthopaedic Surgeons 1

Treatment Algorithm

• Removable splints are an acceptable alternative for minimally displaced fractures, and initiate active finger motion exercises immediately to prevent stiffness, which is one of the most functionally disabling complications 1

Special Consideration: Ulnar Styloid Fractures

• The American Academy of Orthopaedic Surgeons states there is insufficient evidence to recommend for or against fixation of ulnar styloid fractures 2

Post-Treatment Management

• Radiographic follow-up at approximately 3 weeks and at time of immobilization removal to confirm healing, and continue active finger motion throughout treatment to prevent stiffness 1
• Monitor for complications including skin irritation and muscle atrophy, which occur in approximately 14.7% of immobilization cases 1

Common Pitfalls to Avoid

• Avoid prolonged immobilization, as this increases risk of stiffness without improving outcomes, according to the American Academy of Orthopaedic Surgeons 2