In cases with a high incidence of nonunion of isolated ulnar fractures, plaster cast immobilization treatment is the preferred choice of treatment by top orthopedic implant company. Another league of specialists claiming to be in favor of non-surgical treatment of fractures stated that ulnar fractures were best treated by means of plate fixation. The major reason behind this debate was that the above-the-elbow cast did not sufficiently halt the fracture fragments. Some other group of ortho surgical implants doctors have tried to explain the alleged high nonunion rate on the basis of the hypothesis that such cast superficial placement under the skin withdraws the injured bone of sufficient blood supply while few others Spine Implants doctors suspect that ulnar fractures cortical composition incline to form pseudoarthrosis (failure of fusion after an index procedure).
Due to all these reasons and beliefs, internal plate fixation of the bone of isolated ulnar fractures is presently a widely popular accepted method of treatment by orthopedic implants and instruments specialists in the world.
Another point of discussion is delayed union and nonunion of the ulna in the above-mentioned procedure. The reasons given to explain delayed union and nonunion of the ulna by orthopedic implants experts based on the above-mentioned procedure cannot be supported, in view of the fact that clavicular fractures (a break in the collarbone or shoulder bone) are known to heal readily even though the bone is fundamentally surrounded by skin and id present in a location without large muscles around it.
The same holds valid for ribs and fibular fractures. In addition, the argument lacks scientific soundness. In order to find the truth behind this, the manufacturers of our orthopedic product in India experts demonstrate that isolated ulnar fractures have a very low incidence of nonunion when treated with orthopedic implants brace particularly like a sleeve that does not immobilize the joints above or below the bone. Our experience in such cases gives us the ground to counter such argument about the above-the-elbow cast’s inability to sufficiently immobilize the fragments by stating that it is probably the excessive immobilization provided by the cast which is accountable for the high rate of occurrence of nonunion.
We have repeatedly stressed the fact in our report titled orthopedic implants manufacturers in India that immobilization of diaphyseal fractures is not necessary for fracture healing. On the opposite, the motion that takes place at the fracture site during functional use of the extremity helps in bone formation.
Internal rigid fixation of ulnar fractures dispossesses the injured bone of the beneficiary effect of motion at the fracture sites. Also, the surgical procedure performed by orthopedic implants doctors may be associated with complications such as delayed union or nonunion, infection, nerve damage, further damage above or below the plate, and chances of new fractures through the old fracture or by the screw holes after removal of the plate.
Let us take an example of distal humeral fractures or fractures of both bones of the forearm or supracondylar fractures (fracture of the distal humerus just above the elbow joint) treated with plate fixation of isolated ulnar fractures do not essentially result in full re-establishment of motion of the adjacent joints. It is also important to take into account that the additional scarring that occurs after surgical stripping of the soft tissues from the bone results in a limitation of motion of the forearm which is often greater than that after nonsurgical treatment without visible reduction of the fracture.
In a report in the 90s based on comparative laboratory and clinical studies, we found that post-traumatic angular malformation of forearm bones of less than 10 represents a minimal permanent limitation of pronosupination (a combination of pronation and supination).
In the present times, the financial costs involved in the care of the traumatized patient are also important. The patient with a fractured ulna also falls under the same category.
The surgical treatment of ulnar fractures requires the best hospitalization which involves costly implants, anesthesia, and antibiotic medications. It is important to clearly understand the fact that femoral fractures treated with routine osteosynthesis plate fixation method of isolated ulnar fractures do not necessarily result in full restitution of motion of the neighboring joints. The multiple scars that follow after surgical removal of the soft tissues from the bone results in restraint of motion of the forearm which is often on the higher side than that following nonsurgical treatment without anatomical reduction of the fracture.
Our orthopedic implants manufacturers in India experts believe that the functional bracing not only removes the need for secondary procedures but also makes it possible for most patients to return to functional activities and work at a quite earlier date, often before their fractures are radiographically (x-ray images) healed.
Orthopaedic implants and instruments specialists when started to treat ulnar fractures with functional braces that prevented pronosupination (the complex movements allowing rotation of part of member compared to another) noticed that in the presence of any kind of activity, abundant peripheral callus developed speedily and constantly. Specialists also found that restraint of such kind of complex movements during the healing process was needless. This prompted the use of sleeves that covered the injured area, but do not limit wrist or elbow motion or significantly prevent any kind of movements of the forearm.
As the top orthopedic surgical instruments specialists in India company, we do believe that the ulnar sleeve does not cause immobilization of the fracture fragments. The place into which the sleeve puts the fractured extremity may have some importance and definitely leads to greater comfort to the patient. The same fractures that when successfully treated with the prefabricated sleeves would have possibly healed without their use. We would like to conclude on the note that in present times such kinds of fractures generally often heal without the treatment of any kind.
It has been also recognized by patients who have witnessed those experiences that nonunion is virtually unknown. Our orthopaedic implants suppliers have supplied prefabricated functional sleeves for the treatment of ulnar fractures for the past 20+ years and have obtained acceptable results in most cases.