Comparison of clinical outcomes of conservatively treated type 5 and type 6 fractures in distal radius according to frykman classification

Abstract

Aim: Distal radius fractures are among the most common upper extremity fractures and are often associated with ulnar styloid fractures. Ulnar styloid fractures can potentially lead to instability and pain in the distal radioulnar joint. This retrospective study aims to investigate the clinical and radiological effects of ulnar styloid fractures in conjunction with distal radius fractures. Material and Methods: In this retrospective study, 64 (group 1: 33 patients, group 2: 31 patients) patients with distal radius fractures were enrolled. Specifically, patients with type 5 and type 6 fractures, according to the Frykman classification, were included in the study from January 2016 to December 2022. All patients in this study received conservative treatment at Selcuk University Orthopaedics Clinic. Results: Furthermore, there were no significant differences observed between the groups in terms of fracture type, range of motion, pain and instability in the distal radioulnar joint (DRUJ), grip strength, Visual Analog Scale (VAS) scores, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, as well as Gartland-Werley and Green & O'Brien tests. Comparison of clinical and radiological parameters between the groups revealed no statistically significant differences. Discussion: The impact of ulnar styloid fractures on distal radius fractures is not fully illuminated in the literature. While it is claimed that styloid fractures may affect the TFCC and that ulnar-sided pain could be persistent, opposing views suggest that the outcome remains unchanged. In our study, our radiological and functional comparisons also indicated that the result did not change statistically. In summary, regardless of whether an ulnar styloid fracture accompanies distal radius fractures, it does not appear to significantly impact the outcomes.