External fixation for open proximal ulnar fractures

We describe our experience with the use of a pyramidal configuration external fixator in the management of open fractures of the proximal ulna. A prospective study was conducted. 21 patients with open fractures of the proximal ulna (Gustilo-Anderson Grade II and III A) were treated by the application of a new fixator frame. The soft tissue injury was managed with the help of the plastic surgeons. All the patients were followed up clinically and radiologically for a total duration of 3 years after the injury. They were rated on a combined objective and subjective assessment scale by an independent observer. All the patients were rated as good to excellent at the end of a 3 year follow up. The main advantages were simplified wound care and ease of supplementary plastic procedures. No vascular or neurological complications were encountered. The average time taken for union with the fixator was 9 weeks. All the fractures united well. Mobility and function of the elbow were preserved in all cases.