ULNAR SHAFT [Case 2] · Plate and Screws

Even minimally displaced ulnar diaphyseal fractures, if inadequately managed, can directly compromise pronation and supination. This training objectively demonstrates plate osteosynthesis on the tension side cortex, emphasizing tissue preservation and interfragmentary compression, presented in 4K video from a surgical perspective.

TRAINING FOCUS

• Plate osteosynthesis of ulnar diaphyseal fracture.
• Approach between the extensor carpi ulnaris and flexor carpi ulnaris.
• Preservation of the periosteum and muscle-sparing approach.
• Compression technique with pre-tensioned plate.
• Anatomic reduction with different instrumental strategies.

DETAILED CONTENT

• Precise Intermuscular Approach: Identification and safe dissection of the plane between the ECU and FCU, preserving muscle integrity.
• Biological Preservation of the Fracture Site: Controlled opening of the periosteum with a scalpel, maintaining vascularization and promoting consolidation.
• Controlled Anatomic Reduction: Progressive use of instruments (including alternatives such as Kelly clamps) for safe reduction.
• Implantation on the Tension Side Cortex: Correct positioning of the plate on the dorsal ulnar cortex for biomechanical optimization.
• Plate Pre-tensioning: Practical application of tensioning to generate effective compression at the fracture site.
• Interfragmentary Compression Technique: Use of an eccentric screw in an oval hole for primary stability.
• Rational Fixation Sequence: Screw insertion strategy for progressive reduction control.
• Soft Tissue Protection: Layered closure with periosteal and fascial reconstruction, reducing impact on tissues.
• Intraoperative Functional Validation: Immediate evaluation of pronation and supination after fixation.

INCLUDED MATERIAL

Detailed PDF: Structured material with a step-by-step guide to ulnar osteosynthesis, including surgical planning, anatomical references for the intermuscular approach, principles of periosteal preservation, plate pre-tensioning technique, interfragmentary compression sequence, and guidelines for layered closure and functional evaluation.

Apply biomechanical principles with precision and predictability in surgical practice. Enroll and refine your execution in ulnar osteosynthesis.