Primary excision of the ulnar head for fractures of the distal ulna associated with fractures of the distal radius in severe osteoporotic patients.

We performed primary excision of the ulnar head on 23 patients over 70 years of age with severe comminuted fractures of both the distal radius and ulna. The distal radius fracture was fixed rigidly with a volar locking plate, and the ulnar head was resected at the fracture site. All the distal radial fractures united without major complications. The mean wrist flexion/extension arc was 122°, the mean pronation/supination arc was 164°, and grip strength was 69% of that on the contralateral side. All patients returned to their daily activities within a short time without any additional surgical treatment. For elderly patients, primary excision of the ulnar head is an effective treatment for comminuted distal radius and ulna fractures.