Although isolated fixation methods, such as intramedullary nails or plate fixation, are commonly employed, certain fracture patterns-particularly comminuted, osteoporotic, or unstable fractures- represent a challenge to achieve stable fixation and restoring normal anatomy .

Dual fixation, combining an intramedullary nail with a low-profile 2.7-mm mini locked plate, aims to capitalize on the strengths of both techniques-a concept known as "orthogonal or hybrid stabilization". This combined approach provides enhanced biomechanical stability, allows for early mobilization by sharing the mechanical load, and minimizes the risk of non-union or hardware failure. Studying the clinical and radiological outcomes of this dual fixation strategy is essential to establish its efficacy and safety in managing complex distal ulna fractures.

Inclusion Criteria:

• Displaced distal ulna fractures either isolated or with associated distal radius fractures.
• Unstable distal ulna fractures
• Age group: [Adults aged 18 years and older].

Exclusion Criteria:

• Open fractures with severe soft tissue injury (Gustilo type III).
• Pathological fractures.
• Patients with systemic conditions affecting bone healing e.g. uncontrolled diabetes and severe osteoporosis.