Radius Styloid Process Fractures Treated with Break-Away Screws: Two Cases Report

Abstract

three meters high was admitted to the emergency room with right wrist pain. Radiographs showed a radius styloid process fracture (Chauffeur's fracture, AO classification: type B1) with no displacement (Figure 2). Surgical technique The procedure was performed under locoregional anesthesia and tourniquet inflated to 250mm Hg after exsanguination of the extremity. One cm longitudinal incision was made on the radius styloid process. Dissection of soft tissue was performed with taking care of extensor pollicis brevis, abductor pollicis longus and superficial branch of radial nerve. Guide wire was inserted from tip of the radius styloid process. After surgeon recognized no displacement in fluoroscopy, break-away screw (Acutwist®, Nihon Medical Next, Osaka, Japan) can be inserted as same direction as guide wire. The operative incision was covered with sterile bandage and fixation called for no immobilization after operation. Historical Perspective The goal of treatment of radius styloid process fractures are not only to restore the articular congruity of the end of the radius but also to restore the length, alignment and integrity of the supporting volar capsular ligaments of the wrist [1]. Usually, radius styloid process fractures without displacement are treated with immobilization. However, immobilization of the wrist needs at least 4 to 6 weeks [1,2]. However, clinicians or surgeons have to attend the wrist contracture after immobilization. We treated two radius styloid process fractures without displacement with osteosynthesis using break-away screws. Case reports and indication Case 1: A 45-year-old male patient who has felt down on the boat when he was fishing in the fishing boat was admitted to the emergency room with left wrist pain. Radiographs showed a radius styloid process fracture (Chauffeur's fracture, AO classification: type B1) with no displacement (Figure 1A and B). Since he was eager to return to his work quickly, osteosynthesis was chosen for this patient, and preservation of wrist and hand contractures due to splint fixation.