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At least 109 records · Page 6Linked to original sources
PubMed2000

[Resection of the head of the ulna in patients with rheumatoid arthritis].

PURPOSE: The purpose of the study was to investigate value and effect of distal ulna resection (Darrach procedure) on the wrist in rheumatoid arthritis. CLINICAL MATERIAL: From 1985 to 1995, resection of the distal ulna was performed in 47 patients (54 hands) with rheumatoid arthritis. 38 patients (6 men, 32 women, 43 hands) had an average clinical and radiological follow up of 4.7 years (range 3 to 13 years). RESULTS: 15 of the cases with rheumatoid arthritis were pain-free, 19 complained about pain after severe stress, seven complained about pain after mild stress and two about continuous pain. 85% of the patients had a range of motion (pro- and supination) of more than 120 degrees. 75% of the patients had a good or very good wrist function. In 32 cases, the patients were absolutely satisfied with the operative outcome, in five cases, they had expected more improvement. Six reported, that there was no change due to the operation. CONCLUSION: The results demonstrate that the main indication for the resection of the distal ulna is rheumatoid arthritis. This operation does not influence the progress of rheumatoid arthritis. Preoperative radiological changes (Larsen's classification) have the main prognostic value. In Larsen's II and higher, a partial arthrodesis is recommended.

Adult↗
PubMedDate not supplied

[Results of resection of the head of the ulna].

A follow up of 57 wrists with resection of caput ulnae shows different value to different groups of patients. The painful arthrosis of distal radioulnar joint gives indication in posttraumatic cases. Release of pain and improvement of range of motion will be achieved; loss of strength is the most impairing problem for younger patients. 13 patients out of 21 with posttraumatic deformities were satisfied with the post-operative outcome; 13 patients showed significant loss of strength, too. In case of rheumatoid arthritis with caput-ulnae-syndrome the resection is without alternative, needs to be combined with the arthrodesis of radiolunar-joint, if necessary. 20 of 34 rheumatics were satisfied with the outcome after resection of caput ulnae; in 6 cases an ulnar drift was evident, which implied simultaneous or later partial arthrodesis of the wrist. For all patients release of pain decided on their satisfaction with surgery.

Adult↗
PubMed2003

CD99 positive adamantinoma of the ulna with ipsilateral discrete osteofibrous dysplasia.

An adamantinoma is a rare, low-grade malignant, osteolytic bone tumor occurring predominantly in the diaphysis of the tibia. Osteofibrous dysplasia has been suggested as a precursor lesion to adamantinoma. Evidence for the relationship between these two tumors is based on their similar histologic features, immunohistochemistry, shared clonal abnormalities, overlapping skeletal distribution, and simultaneous occurrence in the tibia and fibula. The ulna is an unusual site of involvement by adamantinoma and osteofibrous dysplasia. Simultaneous involvement of the ulna by adamantinoma and ossifying fibroma has not been previously reported. A case is presented of an adamantinoma of the distal ulna with unique pathologic features occurring with an ipsilateral discrete focus of osteofibrous dysplasia as additional evidence of the relationship between these two lesions.

12E7 Antigen↗
PubMed2004

Delayed union and non-union of the ulna following intramedullary nailing in children.

Most studies report little or no problem with union following intramedullary nailing of fractured forearm bones in children. The bone involved in the occasional delayed union is not mentioned except for one delayed union of the ulna following an open fracture. The present paper specifically highlights problems with union of the ulna following nailing in children. It reports two cases of delayed union and one non-union following nailing of closed fractures of both forearm bones. In all cases, the radius united in good time. We discuss the anatomical reasons and surgical techniques that predispose the ulna bone to delayed union and non-union and recommend surgical precautions to avoid this.

Bone Nails↗
PubMed1989

Late onset bone marrow failure associated with proximal fusion of radius and ulna: a new syndrome.

Members of two unrelated families, one from England and the other from Portugal, presented with aplastic anaemia. Both families had clinical and laboratory features in common. The proposita presented with progressive bone marrow failure in adult life involving all three haemopoietic cell lines. In both families individuals with bone marrow failure also had proximal fusion of the radius and ulna bilaterally which segregates as an autosomal dominant trait. No cytogenetic defect was identified in myeloid or lymphoid cells, sampled from the marrow and peripheral blood. Proximal fusion of the radius and ulna is uncommon and its co-existance with late onset bone marrow failure may indicate an association. Growth failure, non-skeletal congenital malformations and cytogenetic abnormalities were absent suggesting that this syndrome is distinct from Fanconi's anaemia. The onset in adult life of generalized bone marrow failure involving all three haemopoietic cell lines associated with proximal fusion of the radius and ulna also makes this syndrome distinct from the thrombocytopenia with absent radii (TAR) syndrome.

Adolescent↗
PubMed2004

The subchondral split line patterns of the medial coronoid process in canine ulnae.

The subchondral split line patterns of the canine medial coronoid process (MCP) were compared with fragmentation line patterns of the MCP in case of elbow dysplasia. Split line patterns were determined in paired ulnae from the killed 26 large-breed dogs ranging in age between 0.8 and 15 years and in two ulnae affected by fragmentation of the MCP. The macerated ulnae were degreased with methylene chloride and decalcified in 5% nitric acid. The subchondral bony layer was pierced at right angles in regular intervals using a round needle that was dipped in black liquid acrylic colour. Three main types of split line patterns could be differentiated (i.e. a sagittal type, a transverse type and an intermediate type). In the sagittal type, split lines were aligned in parallel to the lateral border and at right angles to the rim of the tip and medial border of the MCP. In the transverse type, split lines were orientated in a transverse line to both collateral borders. The intermediate type was characterized as a transition type between sagittal and transverse type as the split lines were aligned obliquely to the longitudinal axis of the MCP. These three types corresponded well with the fissure and fragmentation line patterns of the MCP. The present findings strongly suggest an association between split line pattern and type of fragmentation of the MCP.

Animals↗
PubMed1994

The sequelae of distal ulna physeal dyschondroplasia (osteochondrosis) lesions in breeding swine--a radiological investigation in Danish Landrace pigs.

A radiological follow-up study of osteochondrotic lesions in the distal ulna was carried out in 58 Danish Landrace breeding sows for a period of 15 months (October 1992 to December 1993). This was part of a major project involving the radiological investigation of articular-epiphyseal and physeal development to investigate osteochondrotic lesions in pigs. The radiological lesions were graded from 1 to 5 with increasing severity. It was observed that not all pigs passed through all grades. Only 21% of the pigs had no radiological osteochondrotic lesions (grade 1) during the first radiography series. After 5-7 months, the number of pigs without osteochondrotic radiological lesions were observed to have increased dramatically (21-69%), but the converse was true for grades 2 (mild), 3 (moderate), 4 (severe) and 5 (very severe): (33-17%), (21-9%), (19-5%) and (7-0%) respectively. This was observed with increasing age and weight. The 3rd radiography series indicated that the percentage of pigs without osteochondrotic lesions increased up to 82%, and that grades 2, 3, and 4 had fallen to 14%, 2% and 2% respectively, while grade five remained at 0%. This indicated that the distal ulna osteochondrotic lesions can be important in breeding pigs during the period of growth before first pregnancy. During the first pregnancy the osteochondral ossification fault can be corrected, and the lesions heal. The ulna growth plates were not closed at the second, but mostly closing during the third radiography series.

Animals↗
PubMed2003

Large segmental radius and ulna defect treated by bone transportation with the Ilizarov technique.

An 8-year-old male Boxer with a severely contaminated open fracture of the left radius and ulna fracture, produced by a helicopter propeller, was treated using bone transport by the Ilizarov method. Extensive diaphyseal bone loss and soft-tissue vascular damage were present. The radius and ulna were stabilised with an Ilizarov ring external fixator. The bone defect was partially shortened and restored by gradual transport of a bone segment created from proximal segments of the radius and ulna. The external fixator was removed 4 fi months after the beginning of the latency period, due to instability caused by osteolysis around the wires. A cast was placed for 3 weeks. Although the bone transport had resulted in formation of approximately 4 cm of bone, the antebrachium showed approximately 50% shortening when compared to the contralateral limb. The infection was eradicated, and the dog was able to bear weight on the operated limb when walking.

Animals↗
PubMed1998

Osteotomy of the radius and ulna for the Madelung deformity.

The Madelung deformity can result in pain and decreased function of the wrist and hand. None of the surgical techniques available has been shown consistently to improve grip strength, range of movement or relieve pain. In this prospective study we have treated 18 patients with the Madelung deformity (25 wrists) by wedge subtraction osteotomy of the radius and shortening of the ulna. Our results show statistically significant improvement in grip strength and range of movement of the wrist and forearm. Pain improved in 80% of the patients and 88% were satisfied with the appearance. One patient had a wound infection and another developed reflex sympathetic dystrophy. Two had some recurrence due to continued growth of the ulna and it is recommended that the procedure be delayed until skeletal maturity, or else combined with epiphysiodesis of the ulna.

Adolescent↗
PubMed2001

Proximal ulna shaft fractures and associated compartment syndromes.

In 1996, 6 (7%) of 84 ulna shaft fractures treated at our institution developed compartment syndrome. These 6 isolated, comminuted, proximal-third ulna fractures were secondary to low-velocity gunshot (5) or high-velocity blunt trauma (1). The 5 gunshot-induced fractures did not initially require immediate surgical intervention, but increasing compartment pressure prompted fasciotomy and open reduction and internal fixation. The blunt trauma fracture developed compartment syndrome while the patient awaited surgery; emergent fasciotomy and open reduction and internal fixation were performed. Three patients had vascular injury (interosseus system). The orthopedist must have a high index of suspicion for compartment syndrome in association with isolated, comminuted, proximal-third ulna fractures.

Adolescent↗
PubMed2004

Staphylococcal diaphyseal subacute osteomyelitis of the ulna in a child: an unusual cause of post-traumatic forearm swelling.

Paediatric subacute osteomyelitis (SAO) presents a diagnostic and therapeutic challenge to clinicians. Typically located in the metaphysis of long bones, diaphyseal SAO of the upper limb is rare. We present the case of a three-year-old girl referred to our fracture clinic as an occult fracture following trauma to her forearm with normal initial radiographs. Follow-up radiographs one week later showed cortical erosion of the distal ulna, while a subsequent MRI scan showed soft tissue swelling with an area of high signal in the distal ulna. A limited biopsy diagnosed staphylococcal subacute osteomyelitis of the ulna. The patient responded to high dose antibiotic therapy and made a full recovery. We present this case to highlight the high index of suspicion required to diagnose and appropriately manage this insidious condition, which may easily be confused with any number of benign and malignant bony lesions and provide a review of the relevant literature.

Anti-Bacterial Agents↗
PubMed2004

Vascular anatomy of the radius and ulna diaphyses in their reconstructive surgery.

The vascular factor in the unsuccessful healing of the osteotomised forearm bone is widely discussed in literature at the so-called "level operations" aiming at correcting the "ulna minus" variant in Kienböck's disease. The purpose of our study was to trace the nourishing vessels of the forearm bones from their source from which a. nutritia radii (ANR) and a. nutritia ulnae (ANU) is separated and to locate the foramen nutritium (FN) of the radial and ulnar bones diaphysis. The forearms of 70 upper extremities were dissected and 204 macerated radial bones and 134 macerated ulnar bones were investigated scopically and metrically. The results demonstrated that there is less variability of sources from which ANR was separated as compared to the variability of the sources from which ANU was separated. Foramen nutritium radii (FNR) and foramen nutritium ulnae (FNU) were located mainly along facies anterior and its edges margo anterior and margo interosseus and only in a few cases they were observed along facies posterior. The metrical investigations showed that FNR were located mainly in the second fourth along the bone length, between 30 and 40% from the radial bone length in the distal direction. FNU were located mainly in the second fourth along the bone length, between 30 and 50% from the ulnar bone length in the distal direction. The results for vascular anatomy of the forearm bones give grounds to assume that osteotomy with a subsequent shortening of the radius is more feasible than osteotomy with ulnar lengthening. The distal half of the radius, between the third and fourth quarter in particular, is also recommended as most suitable for surgical intervention.

Aged↗
PubMed2005

Osteoblastoma of the proximal ulna, an unusual cause of ulnar wrist pain. A case report.

During the diagnostic investigation of a patient with ulnar wrist pain, a hot spot in the proximal ulna was revealed on the technetium scintigram, which was found on radiographs to correspond to an osteolytic lesion in the proximal ulna. The lesion was resected and the histological diagnosis was an osteoblastoma. The wrist symptoms disappeared after resection of the lesion in the proximal ulna.

Adult↗
PubMed1991

Congenital bowing of the ulna and aggressive fibromatosis.

The association of skeletal anomalies and aggressive fibromatosis has been documented. Isolated bowing of the ulna is rare, yet its occurrence, particularly in conjunction with congenital dislocation of the radial head, has been documented. This article presents two cases of ulnar bowing in which the patients subsequently developed aggressive fibromatosis. We feel that aggressive fibromatosis may be a latent manifestation of congenital bowing of the ulna. The course of the disease appears to be of an aggressive nature, and patients who present with bowing of the ulna should be followed for the potential development of this disease.

Adolescent↗
PubMed1991

Distal ulna resection, extensor carpi ulnaris tenodesis, and dorsal synovectomy for the rheumatoid wrist.

We conclude from this study that distal ulna resection coupled with stabilization by ECU tenodesis is a highly useful technique with a reproducibly successful outcome for DRUJ destruction resulting from rheumatoid arthritis. In this series, like those noted previously, alleviation of pain, preservation of wrist mobility, prevention of tendon rupture, and improved function have been consistently observed. Moreover, with adjunctive dorsal synovectomy this combined procedure has proved applicable to cases demonstrating not only mild but also moderate stages of radiocarpal disease, thereby avoiding the more extensive and less desirable surgical alternatives of complete wrist arthrodesis or total wrist arthroplasty. Recognizably, the long-term benefit of this surgery depends on maintaining stability of both the reconstructed radioulnar joint and the synovectomized radiocarpal joint. Although the data reported herein strongly support the efficacy of the tenodesis in preserving distal ulna stability and similarly indicate a favorable influence on maintenance of radiocarpal architecture, one must be cognizant that progressive radiocarpal deterioration is a characteristic, albeit somewhat unpredictable, manifestation of the chronic rheumatoid process, and is the principal factor apt to compromise an initially satisfactory result. In such cases demonstrating excessive carpal malalignment preoperatively and for those with an unremitting postoperative course of ulnar translocation or volar subluxation, additional radiocarpal stabilization, preferably by arthrodesis, is essential to salvage the benefits of distal ulna resection and ECU tenodesis.

Adult↗
PubMed1988

Fracture of the upper end of the ulna associated with dislocation of the head of the radius in children.

Dislocation of the head of the radius associated with fracture of the upper end of the ulna is a common elbow injury in children. The literature on diagnosis, however, is relatively limited. The injury can be misdiagnosed and consequently mismanaged. In the present series of 46 children, the age range was from 2.5 to 12 years. The dislocation of the radial head was lateral in 50% of the cases, posterolateral in 28.2%, anterolateral in 17.4%, and anterior in 4.3%. Thorough clinical and radiological examinations are essential. Simple bending of the upper end of the ulna may help to avoid missing an associated subluxation or dislocation of the radial head. The lower end of the forearm bones should be included in the roentgenographic examination; in 11 out of 46 children (26%) the dislocation of the elbow was associated with a fracture of the lower end of the ipsilateral radius and ulna. Closed reduction is the treatment of choice but if this fails, operative treatment should follow without delay. Posterior interosseous nerve palsy was noted in eight patients (17%), but recovered fully in all of the treated cases.

Child↗
PubMedDate not supplied

[The relative length of the radius and ulna at the wrist joint].

The average relative length of radius and ulna on the wrist joint was measured. The 922 examined joints (637 patients) were divided into groups corresponding to age. Up to the age of 50 the relative length of the both forearm bones is the same. Then the ulna surpasses the length of the radius a little. The maximum difference amounts to 1 mm. We support the cause in a decrease of cartilage thickness of caput radii and capitulum humeri which is greater than a simultaneous decrease of cartilage thickness in humero-ulnar joint. In senility the small difference disappears again. The standard deviation is rather considerable, it means a great individual fluctuation. Besides we have examined the elevation of processus styloideus radii et ulnae and their distance. This values were very constant.

Adolescent↗