ULNAR SHAFT [Case 2] · Plate and Screws

Ulnar shaft fractures, even with minimal displacement, can directly compromise pronation and supination when managed inadequately. This training objectively demonstrates osteosynthesis with a plate on the tension cortex, with emphasis on tissue preservation and interfragmentary compression, presented in 4K video under a surgical perspective. TRAINING FOCUS Osteosynthesis of ulnar shaft fracture with plate. Approach between the extensor carpi ulnaris and flexor carpi ulnaris. Periosteal preservation and muscle-sparing approach. Compression technique with pre-tensioned plate. Anatomical reduction using different instrumental strategies. DETAILED CONTENT Precise Intermuscular Approach: Identification and safe dissection of the plane between ECU and FCU, preserving muscular integrity. Biological Preservation of the Fracture Site: Controlled opening of the periosteum with a scalpel, maintaining vascularization and favoring consolidation. Controlled Anatomical Reduction: Progressive use of instruments (including alternatives such as Kelly forceps) for safe reduction. Implantation on the Tension Cortex: Correct positioning of the plate on the dorsal cortex of the ulna 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 control of reduction. Soft Tissue Protection: Layered closure with reconstruction of the periosteum and fascia, reducing impact on tissues. Intraoperative Functional Validation: Immediate assessment of pronation and supination after fixation. INCLUDED MATERIAL Detailed PDF: Structured material with the step-by-step of 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 assessment. Apply biomechanical principles with precision and predictability in surgical practice. Enroll and refine your execution in ulnar osteosynthesis.