Distal ulnar and distal radial fractures are rare injuries, accounting for approximately 5.6% of all distal radial fractures. There is some controversy regarding the treatment methods for distal ulnar fractures. Some literature suggests that the clinical outcomes of distal ulnar fractures treated conservatively are poor. Unstable distal ulnar fractures may affect the function of the distal radioulnar joint and forearm rotation stability, leading to nonunion, chronic wrist pain, and instability. Consequently, some scholars recommend surgical treatment for unstable or displaced distal ulnar fractures after fixation of the distal radial fractures. For small distal ulnar fracture fragments, particularly in elderly patients with osteoporotic fractures, the effectiveness of internal fixation methods such as Kirschner wires or locking plates is limited. In comparison, the ulna distal locking hook plate presents advantages in anatomical design and smooth edges, reducing irritation to soft tissues and decreasing the risk of reduction loss, thus achieving a more robust fracture fixation.

To retrospectively analyze the clinical effect of hook-plate osteosynthesis in the treatment of unstable distal ulnar fracture combined with distal radial fracture.

Thirty-one cases of unstable distal ulnar fractures combined with distal radial fractures were admitted to our hospital from January 2018 to May 2022 and selected as the subjects for the study. Clinical efficacy assessment included wrist joint range of motion, grip strength, Q-DASH score, and Mayo wrist joint score. Postoperative X-ray evaluations were conducted to assess radial height, ulnar variance, volar tilt, ulnar tilt, and fracture healing status.

Thirty-one patients were included in this study, with an average age of (66±9) years and a mean follow-up duration of (15±3) months. At the final follow-up, the average wrist joint range of motion was as follows: (49±7) ° of palmar flexion, (45±6) ° of dorsiflexion, (81±4) ° of pronation, and (79±5) ° of supination. Grip strength measured (19±6) kilograms. Clinical assessments ranged from good to excellent, with an average Q-DASH score of (14±9) and a Mayo wrist joint score of (87±7) .

The hook plate is an ideal choice for surgical treatment in patients with unstable distal ulnar fractures combined with distal radial fractures. Satisfactory recovery of wrist joint function can be achieved through early rehabilitation exercises.