Should an Ulnar Styloid Fracture Be Fixed Following Volar Plate Fixation of a Distal Radial Fracture?

Abstract

An accompanying ulnar styloid fracture in patients with stable fixation of a distal radial fracture has no apparent adverse effect on wrist function or stability of the distal radioulnar joint.

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.…”

Outcomes After Volar Plate Fixation of Low-grade Open and Closed Distal Radius Fractures Are Similar

“…The minimal clinically important difference of a DASH score for a patient with a wrist problem has been reported to be approximately 10 [22], and the SD of a DASH score in a distal radius fracture also is approximately 10 [9,10]. A sample size of 18 patients in the open fracture group and 40 in the closed fracture group at 1 year after surgery would provide 92% power with a Type I error rate of 0.05.…”

Distal radius kırıklarının cerrahi tedavisi

“…İnstabilitenin eşlik ettiği ulna stiloid taban kırıklarının tespiti önerilmektedir (Şekil 7). [31,32] Limitli açık redüksiyon ve internal tespit Kapalı redüksiyon sonrası anatomik redüksiyonu sağlanamayan bazı kırık parçaların yumuşak doku bağlantılarını ve dolaşımlarını bozmayacak şekilde parçanın yerine yönelik yapılan kısıtlı insizyonlardır. Parça tespitleri K-telleri ya da bölge için yapılmış özel implantlar ile yapılabilir.…”