PROXIMAL ULNAR FRACTURES IN ELDERLY PATIENTS TREATED BY TENSION BAND WIRING: REVIEW OF OUR SERIES

Introduction: Optimal treatment of proximal ulnar fractures remains a controversial topic in traumatology. Aim of our study was to ascertain the value of tension band technique with figureof- eight wire for treating simple and comminuted displaced fractures of proximal ulna, thus achieving good reduction and early mobilisation.Methods: Between January 1994 and December 1998, fortythree consecutive patients underwent open reduction and internal fixation using tension band technique with figure-of-eight wire. Among them, 26 patients (9 males, 17 females) were in the age range 50–89 (mean age 68) and were identified for this study. We classified the fractures according to AO classification, based on the radiographic findings. In 23 cases we had the opportunity to perform a clinical and radiological assessment after the surgical treatment. The mean follow-up was 61 months, with a minimum follow-up of 36 months. Three patients were lost at follow-up. In the 23 evaluated patients, we considered the mechanism of injury, the associated lesions, the postoperatory length of immobilization, the rehabilitation duration, and the immediate as well as late complications. We further analysed the elbow functionality according to the criteria of the Mayo Elbow Performance Score (MEPS). Regarding the long-term radiographic evaluation, we used the Murphy rating criteria, including assessment of trochlear notch contour defect and joint narrowing. Results: The results obtained by integrated analysis of MEPS and radiological assessment were: 16 excellent, 3 good, 3 fair, 1 poor. Complications occurred in 4 cases. Conclusions: Our work showed the validity of this technique in elderly patients with displaced proximal ulnar fractures.