Proximal ulna fracture dislocations (PUFDs) encompass a wide spectrum of injuries from relatively benign isolated ulna fractures to highly complex fractures with multiple osseous and ligamentous components. Classification of these injuries is challenging with few validated systems which generally focus on only one aspect of the injury. Surgical management of these injuries remains fraught with high rates of complications and poor long-term outcomes, and any subsequent salvage surgery is often extremely challenging. The aim of this review is to provide a framework for the evaluation and surgical management of these injuries using simple pathoanatomical principles where each key component of a PUFD is considered in turn, along with suggested surgical strategies and tips and tricks gleaned from the authors’ clinical experience and available literature.
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