Repair of the triangular ligament in Colles' fracture: No effect in a prospective randomized study

Abstract

We present a prospective and randomized study of two different treatments of extraarticular Colles' fracture with a fractured ulnar styloid. The study comprised 41 patients with 2 years' follow-up; 22 patients were treated with closed manipulation and an above-the-elbow plaster cast, whereas in 19 patients the avulsed ulnar styloid was transfixed and/or the triangular ligament was repaired after closed reduction of the fractured radius. In all the operated on patients, a complete rupture of the triangular ligament was found. Good reduction of all the fractures was achieved primarily according to the radiographic examination. At follow-up the alignment had deteriorated, with no difference between the two treatment groups. Neither did the findings in the wrist arthrograms differ between the two groups nor did the subjective complaints of the patients. We conclude that repair of the ruptured triangular ligament in extraarticular fractures of the distal radius is not better than conventional treatment.

Ulnar wrist pain after Colles' fracture: 109 fractures followed for 4 years

“…Reeves (1966) and Burgess and Watson (1988) reported satisfactory results by excision of ulnar styloid fragments for relief of chronic ulnar pain. af Ekenstam et al (1989) found, however, that repair of the ruptured triangular fibrocartilage or avulsed ulnar styloid did not affect the outcome of Colles' fracture. We believe that internal fixation of the avulsed ulnar styloid is not necessary, at least with respect to ulnar wrist pain.…”

Triangular Fibrocartilage Complex Tears Associated With Symptomatic Ulnar Styloid Nonunions

“…[1][2][3][4][5][6][7][8][9] Although nonunion of the ulnar styloid is common after fractures, most nonunions remain asymptomatic despite displacement on radiographs. 8 -13 In symptomatic ulnar styloid nonunions, the origin of the pain may be attributed to abnormal motion from the nonunion site, instability of the distal radioulnar joint (DRUJ), or tear of the triangular fibrocartilage complex (TFCC) with or without DRUJ instability.…”

Ulnar styloid process nonunion and outcome in patients with a distal radius fracture: A meta-analysis of comparative clinical trials

“…Of those patients, 44-65% also have an ulnar styloid process (USP) fracture [4][5][6][7]. Displacement of DRFs may result in disruption of the distal radioulnar ligaments, either by direct ligamentous tear or by avulsion of the origin of the ligaments, that is, a fracture at the ulnar fovea or the ulnar styloid [5,6,[8][9][10][11][12][13][14][15][16][17]. Ulnar styloid avulsion may result in distal radioulnar joint (DRUJ) instability due to triangular fibrocartilage complex (TFCC) disruption, the principal stabilizer of the DRUJ [9,[18][19][20][21][22].…”