Classification and treatment of ulnar styloid nonunion

Hauck, Randy M.; Skahen, James R.; Palmer, Andrew K.

doi:10.1016/s0363-5023(96)80355-8

Cited by 149 publications

(132 citation statements)

References 19 publications

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“…The factors associated with this injury, however, rarely have been studied. Because of its anatomic proximity to the triangular fibrocartilage complex, fracture of the ulnar styloid at its base has been postulated to cause DRUJ instability [12,28,33,37]. However, well-designed studies consistently denied the association between symptomatic DRUJ instability and the ulnar styloid fracture in distal radius fractures [15,35,39,44].…”

Section: Discussionmentioning

confidence: 99%

Clinical and Radiographic Factors Associated With Distal Radioulnar Joint Instability in Distal Radius Fractures

Kwon

Seo

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Distal radioulnar joint (DRUJ) instability is an important cause of ulnar-sided wrist pain in distal radius fractures. However, instability is frequently undiagnosed and the clinical and radiographic factors associated with instability are not well understood. Questions/purposes We therefore identified clinical and radiographic factors associated with DRUJ instability in distal radius fractures. Patients and Methods We retrospectively reviewed all 221 patients who underwent surgical treatment for unstable distal radius fractures from 2007 to 2010. Ten patients (five men and five women) had DRUJ instability by intraoperative manual testing (Group I); these patients had a median age of 52 years. The other 211 patients (81 men and 130 women) (Group II) had a median age of 55 years.Clinical and radiographic data were compared between the groups. ResultsThe incidence of open wounds at the wrist and the relative ulnar length measured on the prereduction radiograph were greater in Group I. An open wound at the wrist and positive ulnar variance of 6 mm or greater on the prereduction radiograph increased the risk of DRUJ instability (relative risks = 45 and 17, respectively) in distal radius fractures.

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Section: Discussionmentioning

confidence: 99%

Clinical and Radiographic Factors Associated With Distal Radioulnar Joint Instability in Distal Radius Fractures

Kwon

Seo

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Ulnar detachment can be associated with avulsion fracture at the base of the styloid process (32,33) (Figure 10). Nonunited styloid fracture in chronic TFCC tear with DRUJ instability is not uncommon.…”

Section: Mri Features Of Tfcc Tearmentioning

confidence: 99%

MR imaging of the traumatic triangular fibrocartilaginous complex tear

Ng¹,

Griffith²,

Fung³

et al. 2017

Quant. Imaging Med. Surg.

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Triangular fibrocartilage complex is a major stabilizer of the distal radioulnar joint (DRUJ).However, triangular fibrocartilage complex (TFCC) tear is difficult to be diagnosed on MRI for its intrinsic small and thin structure with complex anatomy. The purpose of this article is to review the anatomy of TFCC, state of art MRI imaging technique, normal appearance and features of tear on MRI according to the Palmar's classification. Atypical tear and limitations of MRI in diagnosis of TFCC tear are also discussed.

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“…7-9 Persistent DRUJ instability following distal radius fracture is often attributed to a disruption of the foveal insertion of the TFCC, which may occur as a purely soft tissue injury but is often identified by the presence of a basiulnar styloid fragment 8,9 However, DRUJ stability may not be restored even when the ulnar styloid fragment is reduced and the foveal insertion of the TFCC is reattached (►Fig. 1).…”

Section: 5mentioning

confidence: 99%

Defining Residual Radial Translation of Distal Radius Fractures: A Potential Cause of Distal Radioulnar Joint Instability

et al. 2014

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Background The aim of this paper is twofold: to raise awareness of the potential problems of leaving residual radial translation of the distal fragment in distal radius fracture fixation and to provide a reproducible, accurate and simple radiographic parameter to define this reduction. The primary goal of all of this is to raise awareness of the malreduction to decrease problems with distal radial ulnar joint instability and to decrease the incidence of what the Authors consider to be unnecessary surgery on the ulnar side of the wrist when the surgeon is confronted with distal radio ulnar joint instability after fixation of a distal radial fracture. The idea is to make the surgeon look at reduction of the radius instead of fixing the ulnar side. We know that in the overwhelming majority of cases in our clinical experience, intraoperative correction of this deformity has avoided the need for ulnar styloid or TFC repair, which we otherwise would have performed had we not been aware of this malreduction. We have deliberately used the word potential in the title to reflect that we are proposing a hypothesis, and that only 40-50 percent of patients have a discrete distal band of the IOM. We have extensive experience over a 15-year period with internal fixation of distal radius fractures and have clearly observed this phenomenon. It is our belief, therefore, that we should be able to present this hypothesis in tandem with the radiographic parameter that we are advocating, to raise awareness of this malreduction of the radius. The radiographic parameter has little relevance unless put into this context. We would consider that the impact and value of this paper would be substantially weakened by removing this component of the title. Patients and Methods In this study, 100 normal wrist radiographs were reviewed by three fellowship-trained orthopedic surgeons to develop a simple and reproducible technique to measure radial translation.

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Classification and treatment of ulnar styloid nonunion

Cited by 149 publications

References 19 publications

Clinical and Radiographic Factors Associated With Distal Radioulnar Joint Instability in Distal Radius Fractures

Clinical and Radiographic Factors Associated With Distal Radioulnar Joint Instability in Distal Radius Fractures

MR imaging of the traumatic triangular fibrocartilaginous complex tear

Defining Residual Radial Translation of Distal Radius Fractures: A Potential Cause of Distal Radioulnar Joint Instability

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