Isolated Ulnar Shaft Fractures Treated with Functional Braces

Objective: To report the results from functional bracing of isolated ulnar shaft fractures. Design: Retrospective review. Setting: Two university hospitals. Patients: Isolated ulnar shaft fractures in 444 patients were stabilized in functional braces that permitted full range of motion of all joints. Intervention: Prefabricated braces that extended from below the elbow to above the wrist were applied within the first week after the initial injury. Outcome Measures: Union of the fracture, fracture angulation, and final range of motion of the forearm were evaluated. Results: Two hundred eighty-seven patients were available for follow-up (65 percent). Union took place in 99 percent of the fractures. Shortening of the ulna averaged 1.1 millimeters (range 0 to 10 millimeters). Final radial annulation averaged 5 degrees (range 0 to 18 degrees). Dorsal angulation averaged 5 degrees (range 0 to 20 degrees). Average loss of pronation was greatest in fractures of the proximal third of the ulna, averaging 12 degrees. Fractures in the distal third averaged a loss of 5 degrees of pronation. Conclusions: Functional bracing is a viable therapeutic alternative in the management of isolated ulnar shaft fractures. It is associated with a 99 percent union rate and good to excellent functional results in more than 96 percent of patients.