Effects of Ulnar Styloid Fractures on Unstable Distal Radius Fracture Outcomes: A Systematic Review of Comparative Studies

Almedghio, Sami; Arshad, Mohd Khairuddin; Almari, Fayez; Chakrabarti, I.

doi:10.1055/s-0037-1607214

Cited by 17 publications

(11 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous biomechanical studies have indicated that the middle column of the distal radius is the hub and primary load-bearing surface, which transmits an axial load to the wrist and has a major role in mechanical conduction (10). The fracture line of the middle column of the distal radius is usually vertical.…”

Section: Discussionmentioning

confidence: 99%

“…The Melone and Fernandez classification systems have been extensively cited by previous studies (17)(18)(19)(20)(21). Although this type of double-column die-punch fracture is widely known, the description of double-column die-punch fractures of the distal radius has not been previously reported (10,22). Therefore, a lack of studies is available regarding the mechanism of the occurrence and classification of double-column die-punch fractures.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Identification of a novel three‑column classification for double‑column die‑punch fractures of the distal radius

Liu¹,

Liu

et al. 2020

Exp Ther Med

View full text Add to dashboard Cite

The present study aimed to classify double-column die-punch fractures of the distal radius according to imaging data, and to evaluate their clinical features. A retrospective analysis of imaging data derived from 498 patients diagnosed with a double-column die-punch fracture of the distal radius was performed. The fractures were divided into those with middle-column avulsion with fracture of the radial-column articular surface (type I), those with middle-column collapse with fracture of the radial-column articular surface (type II), those with middle-column collapse with fracture of epiphysis of the radial column (type III) or mixed-type fractures (type IV). The intra-and inter-observer consistency between assessors was analyzed with kappa statistics. The patients with double-column die-punch fractures of the distal radius were followed up. There were 21 cases of type I fracture, 135 cases of type II fracture, 130 cases of type III fracture and 212 cases of type IV fracture. The intra-observer kappa coefficient ranged from 0.810-0.861, whereas the inter-observer kappa coefficient range was 0.830-0.876, with high consistency. Following 13 months of follow-up, the patients were assessed for functional recovery of the wrist and hand using the Gartland-Werley scoring system. The analysis indicated that in 95.78% of the patients, wrist function was rated as excellent or good (n=477), while in 4.22% of patients it was rated as fair (n=21), mainly due to the development of post-traumatic arthritis of the wrist following inappropriate therapy. All of the cases were type IV and type III fractures. These data demonstrated the application of a novel classification system named the Three-Column Classification, used to classify double-column die-punch fractures of the distal radius. This method reflected the mechanisms and severity of the fractures, conforming to the principle of AO fracture classification. Furthermore, it exhibited high consistency and may provide reference values for clinical diagnosis, treatment and prognostic evaluation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Identification of a novel three‑column classification for double‑column die‑punch fractures of the distal radius

Liu¹,

Liu

et al. 2020

Exp Ther Med

View full text Add to dashboard Cite

show abstract

“…An accompanying ulnar styloid fracture in patients with stable fixation of a distal radial fracture had no apparent adverse effect on wrist function or stability of the distal radioulnar joint . The recent meta‐analyses also showed that no significant difference was found in wrist scores, range of motion, grip strength, pain scores and distal radioulnar joint instability between patients with and without an ulnar styloid process fracture after 1 year of follow‐up …”

Section: Discussionmentioning

confidence: 97%

Factors associated with the decision for operative versus conservative treatment of displaced distal radius fractures in the elderly

Yang

Xie

et al. 2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background: The treatment of senile distal radius fractures had not been clearly defined. The objective of this study was to identify the factors associated with the decision for operative treatment of displaced distal radius fractures in patients aged over 55 years. Methods: Data of 318 patients with displaced distal radius fractures were collected on patient-, fracture-and surgeon-related characteristics that were plausibly related to the decision for operation. Mean comparisons or chi-squared test were used for univariate analysis of the above-mentioned factors, and then multiple logistic regression was used to identify factors associated with the decision for operation. Results: Univariate analysis showed that age, osteoporosis, Charlson score, associated orthopaedic injuries requiring surgery, Orthopaedic Trauma Association (AO) and Fernandez classification, radial height, volar tilt, volar/dorsal comminution, ulnar variance, intra-articular displacement/step-off, associated distal radioulnar joint instability or radiocarpal joint dislocation and subspecialty of treating surgeons had statistically significant association with operative intervention. In the multivariate analysis, the predictors of operative intervention were younger patient age (P = 0.028), associated orthopaedic injuries requiring surgery (P = 0.020), higher AO classification (P = 0.037), higher Fernandez classification (P = 0.041), radial shortening >5 mm (P = 0.020), volar tilt > −10 (P = 0.020), volar/dorsal comminution (P = 0.020), ulnar variance >5 mm (P = 0.023), intra-articular displacement/step-off >2 mm (P = 0.004), associated distal radioulnar joint instability or radiocarpal joint dislocation (P = 0.047) and treatment by an upper extremity specialist (P = 0.038). Conclusion: The decision for surgery was predominantly influenced by the characteristics and severity of the fracture. Patients' age and treatment by an upper extremity specialist were also significant factors associated with a higher likelihood of operative intervention. © 2019 Royal Australasian College of Surgeons ANZ J Surg 89 (2019) E428-E432 ANZJSurg.com © 2019 Royal Australasian College of Surgeons E432Wu et al.

show abstract

“…A recent meta-analysis revealed functional scores favoring distal radius fractures without concomitant ulnar styloid fractures while the outcome difference was not significant in patients with and without ulnar styloid fractures [ 14 ]. In literature review, most of those studies anecdotally evaluated ulnar styloid fractures based on the outcomes of concomitant distal radius fractures and commonly introduced bias assuming more complicated presentation in surgical treated ulnar styloid fractures than non-surgical cases to reach a conclusion of no significant difference [ 15 ]. Besides, surgical concerns existed almost uniquely in styloid base fractures owing to both fixation feasibility [ 7 ] and cadaveric demonstration [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire

et al. 2020

View full text Add to dashboard Cite

Background: Limited reference is available regarding surgical management in symptomatic ulnar styloid fractures with small bony avulsion. The study goal is to report the surgical outcomes using anchor suture fixation with comparison to traditional tension band wire fixation. Methods: We retrospectively reviewed the medical records in patients who underwent surgical repair for unilateral ulnar styloid fractures with distal radioulnar instability between 2004 and 2017. A total of 31 patients were enrolled including two kinds of fixation methods. Anchor suture fixation plus distal radioulnar joint pinning was performed in ten patients with tiny avulsion bony fragments (group A); tension band wire fixation was performed in 21 patients with big styloid fracture fragments (group B). Patient characteristics and 2-year treatment outcomes were compared between two groups based on Mayo Modified Wrist Score (MMWS); Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH); visual analog scale (VAS), and surgical complication. Descriptive statistics were used for calculation of key variables; a p value of < 0.05 was considered statistically significant. Results: Based on Gaulke classification, there were five subtypes in group A and three subtypes in group B. Incidence of concomitant distal radius fractures was significantly higher in group B; other patient characteristics including age, sex, injury side, and time to surgery showed no significant difference. Outcome assessment regarding MMWS, QuickDASH, and VAS was comparable between two groups. Bone-related complications including nonunion, DRUJ subluxation, and styloid resorption were analyzed; the difference was not significant. Incidence of implant-related complications including migration and secondary removal surgery was significantly higher in group B (p = 0.021). Conclusion: Surgical fixation in symptomatic ulnar styloid fractures yields comparable treatment outcomes in both fracture patterns. Implant-related complication with secondary removal surgery is more common in tension band wire group. Anchor suture fixation is a feasible option for tiny styloid avulsion fragments with limited surgical complication.

show abstract

Effects of Ulnar Styloid Fractures on Unstable Distal Radius Fracture Outcomes: A Systematic Review of Comparative Studies

Cited by 17 publications

References 34 publications

Identification of a novel three‑column classification for double‑column die‑punch fractures of the distal radius

Identification of a novel three‑column classification for double‑column die‑punch fractures of the distal radius

Factors associated with the decision for operative versus conservative treatment of displaced distal radius fractures in the elderly

Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire

Contact Info

Product

Resources

About