Effect of an Unrepaired Fracture of the Ulnar Styloid Base on Outcome After Plate-and-Screw Fixation of a Distal Radial Fracture

Abstract

An unrepaired fracture of the base of the ulnar styloid does not appear to influence function or outcome after treatment of a distal radial fracture with plate-and-screw fixation, even when the ulnar fracture was initially displaced >or=2 mm.

Functional Outcome after Surgical Stabilization of Fractures of Distal End of Radius with or Without Ulnar Styloid Fractures- A Comparative Study

“…They concluded that ulnar styloid fracture with displacement more than 2 mm is risk factor for DRUJ instability. Souer et.,al 15 in a matched cohort study of patients with or without ulnar styloid base fracture (76 in each group) having distal radius volar plating and followed up for 24 months, found no measurable differences in motion, strength, pain, or functional scores based on presence of styloid fracture or on initial displacement of more or less than 2 mm. The authors did not specifically assess DRUJ instability before or after surgery.…”

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

“…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]. Recently widening of the DRUJ gap was identified as an independent risk factor for DRUJ instability in distal radius fractures [8].…”

“…However, it still is unclear whether the displaced ulnar styloid fractures cause pain and instability at the DRUJ in patients with distal radius fractures [34,40,44]. One study suggested that stable internal fixation of distal radius fractures results in a stable DRUJ after bony healing regardless of the presence of substantially displaced, unrepaired ulnar styloid fractures [39], whereas two studies [15,35] reported no differences in the wrist function between patients with unrepaired ulnar styloid fractures and those without ulnar styloid fractures. In addition, factors other than ulnar styloid fractures have been investigated only rarely in distal radius fractures for DRUJ instability.…”

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

“…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].…”