WHAT’S THE USE OF THE DISTAL TWO-THIRDS OF THE ULNA ?

Abstract

Purpose: We report three cases of extensive resection of the ulna without reconstruction.

Material and methods: For the first two patients, resection was performed for ulnar tumour, on low-grade osteosarcoma and one adamantinoma. In the third patient with a voluminous giant-cell tumour, the distal part of the ulna was resected and used as a graft for arthrodesis after resection of the distal third of the homolateral radius. Resection involved the distal half, three-quarters, and one-third of the ulna in these three patients.

Results: At follow-up of 4, 23 and 1 year respectively, wrist motion is normal in the two patients and elbow motion is normal in two out of three. None of the patients experienced wrist pain or ulnar stump pain. Grip force decreased in the two patients who underwent isolated ulnar resection.

Discussion: Our observations corroborate reports in the literature leading to the conclusion that reconstruction of the ulna is not justified when one-quarter of the bone can be preserved. The ulna offers an exceptional graft material for reconstruction of the homolateral radius.