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Ulnar Shaft Fracture ORIF 25545

ulnar shaft fracture xray

Forearm Anterior View

ulnar shaft fracture

proximal ulnar shaft fracture xray

CPT Coding Technique
Indications Complications
Contraindications Follow-up Care / Rehab Protocol
Alternatives Outcomes
Pre-op Planning / Case Card Review References

synonyms:Ulnar Shaft Fracture ORIF, ulna fracture ORIF

Ulnar Shaft Fracture ORIF CPT

Ulnar Shaft Fracture ORIF Indications

  • Displaced Middle 1/3 (>50%displacement, >10° angulation)
  • Proximal 1/3: ORIF, even non-displaced fractures have high propensity to displace with time.
  • Displaced Distal 1/3: ORIF

Ulnar Shaft Fracture ORIF Contraindications

  •  Infection
  • Soft tissue compromise

Ulnar Shaft Fracture ORIF Alternatives

  • Functional fracture brace, long arm casting
  • External Fixation

Ulnar Shaft Fracture ORIF Pre-op Planning

  • Ensure appropriate fixation is availble. 
  • Pre-countered plates are now available from various manufactures.
  • Synthes 2.0mm LCP Distal Ulnar plate:
  • Biomet / Hand innovations 2.5mm Distal Ulnar plate

Ulnar Shaft Fracture ORIF Technique

  • Sign operative site.
  • Pre-operative antibiotics, +/- regional block.
  • Supine position. Hand table; tourniquet high on arm; all bony prominences well padded.
  • General endotracheal anesthesia
  • Prep and drape in standard sterile fashion. Arm exsagninated with Esmarch, tourniquet inflated
  • Ulnar fixation via straight dorsal approach along subcutaneous border of ulna. Place plate dorsal surface of ulna beneath the ECU
  • Minimize periosteal stripping and soft tissue dissection as much as possible
  • Expose fracture, reduce and plate using standard AO technique. Generally 8-cortices above and below fracture. For purely transverse fractures 6-cortices (6 hole plate) is effective.
  • Irrigate.
  • Close in layers.

Ulnar Shaft Fracture ORIF Complications

Ulnar Shaft Fracture ORIF Follow-up care

  • Post-op: Volar plaster splint with sling. NWB. Active elbow and finger ROM.
  • 7-10 Days: Wound check, Place in funtional brace (interosseous mold). Begin active pronation/supination. Continue active elbow and finger ROM. Activity restrictions. Use for arm for light ADLS only. NWB.
  • 6 Weeks: Gradually resume normal activites provided bony union is evident on xrays.
  • 3 Months: Consider bone stimulator if union is not evident on xray.
  • 6 Months: return to sports / full activities.
  • 1Yr: Follow-up xrays, assess outcomes.

Ulnar Shaft Fracture ORIF Outcomes

  • Generally heal well in 8-12 weeks
  • Consider hardware removal at 12 months if plate is prominent and painful. 

Ulnar Shaft Fracture ORIF Review References

 

 

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