The incidence of ulnocarpal complaints after distal radial fracture in relation to the fracture of the ulnar styloid

Abstract

Two hundred distal radial fractures, with a mean follow up of 20 months (range 6-49), were divided into three groups according to the presence and healing status of an ulnar styloid fracture. The patients underwent both clinical and radiological examination and completed two different questionnaires. One hundred and one, of 200 distal radial fractures, were associated with an ulnar styloid fracture. Forty-six of these developed an ulnar styloid nonunion. The authors encountered significantly higher pain scores (ulnar sided pain p = 0.012), a higher rate of DRUJ instability (p = 0.032), a greater loss of motion and grip strength (p = 0.001), and a poorer clinical outcome in cases with an ulnar styloid fracture, but no differences were apparent when those with healed ulnar styloid fractures or ulnar styloid nonunions were compared (p > 0.05). The investigators propose that the incidence of ulnocarpal complaints following distal radial fracture depends on the presence but not the healing status of an ulnar styloid fracture.

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

“…In this meta-analysis, no difference in the presence of DRUJ instability was found between the union and the nonunion group. This may be explained because the exact level of the ulnar styloid fracture was unknown in one [25] of the four included studies [25][26][27]30]. In the other three studies, the number of patients with DRUJ instability was too small for further analysis.…”

“…1). Eight studies met our inclusion criteria; however, two studies did not report sufficient data to be included in the meta-analysis leaving six studies available for meta-analysis [24][25][26][27][28][29][30]. These studies included a total of 135 patients in the union group and 230 in the nonunion group.…”

“…Mentzel and colleagues reported a better residual function if the USP fracture unites [24]. Others found that nonunion of the ulnar styloid did not affect functional outcome or pain following volar plate fixation of a DRF [25][26][27][28][29][30].…”

“…Data on clinical DRUJ instability and pain were available in four [25][26][27]30] and all six studies [24][25][26][27]29,30], respectively. For these outcome measures, no significant differences were found between the union and nonunion groups.…”

Distal radius kırıklarının cerrahi tedavisi

“…İnstabilitenin eşlik ettiği ulna stiloid taban kırıklarının tespiti önerilmektedir (Şekil 7). [31,32] Limitli açık redüksiyon ve internal tespit Kapalı redüksiyon sonrası anatomik redüksiyonu sağlanamayan bazı kırık parçaların yumuşak doku bağlantılarını ve dolaşımlarını bozmayacak şekilde parçanın yerine yönelik yapılan kısıtlı insizyonlardır. Parça tespitleri K-telleri ya da bölge için yapılmış özel implantlar ile yapılabilir.…”