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

Chen, Alvin Chao‐Yu; Lin, Yi‐Hsuan; Weng, Chun-Jui; Cheng, Chun‐Ying

doi:10.1186/s13018-020-01795-3

“…VAS scores of the two groups at 4 h, 8 h, 12 h, 24 h, and 48 h after operation were recorded [ 10 ]. With self-made 10 cm long VAS scale, the degree of pain increased from 0 (0: painless) to 10 (10: unbearable pain).…”

Section: Methodsmentioning

confidence: 99%

Comparative Analysis of Clinical Effects of the Cable‐Pin System and Kirschner Wire Tension Band (TBW) Internal Fixation in the Treatment of the Olecranon Fracture

Rao

¹

,

Hu

²

,

Tan

³

2022

Contrast Media & Molecular Imaging

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Objective. To explore the clinical effects of the cable-pin system and Kirschner wire tension band (TBW) internal fixation in the treatment of the olecranon fracture. Methods. Fifty patients with an olecranon fracture were treated in our hospital from April 2018 to March 2020. Patients were randomly divided into control and study groups. The control group was fixed with TBW, and the study group was fixed with the cable-pin system. The operation, the circumference difference between the injured limb and the healthy limb, the VAS score, the excellent and good rate, the recovery of the range of motion of the joint 1 year after operation, and the incidence of postoperative adverse reactions were compared between the two groups. Results. In terms of the operation of the two groups, the operation time, intraoperative blood loss, healing time, incision drainage, and hospital stay in the study group were lower than those in the control group ( P < 0.05). In the comparison of the circumference difference between the injured limb and the healthy limb, there was no significant difference between the two groups before operation ( P > 0.05), but the circumference difference between the injured limb and the healthy limb in the study group was lower than that in the control group at 24 hours, 72 hours, 7 days, and 30 days after operation, and the difference was statistically significant ( P < 0.05). There was no significant difference in the VAS score between the two groups before operation, but 7-day VAS scores at 12 h, 24 h, and 72 h after operation in the study group were significantly lower than those in the control group ( P < 0.05). The excellent and good rate in the study group was excellent in 18 cases, good in 5 cases, fair in 2 cases, excellent in 7 cases, good in 6 cases, fair in 8 cases, and poor in 4 cases in the control group, and the excellent and good rate in the study group (100.00%) was higher than that in the control group (84.00%), and the difference was statistically significant ( P < 0.05). The patients in the two groups were followed-up for one year, and there were no shedding cases in the two groups. In terms of the recovery of range of motion one year after operation, the scores of elbow flexion, extension/degree, and elbow function in the study group were higher than those in the control group ( P < 0.05), and the difference was statistically significant ( P < 0.05). The incidence of postoperative adverse reactions in the study group (4.00%) was significantly lower than that in the control group (28.00%), and the difference was statistically significant ( P < 0.05). The incidence of postoperative adverse reactions was significantly lower in the study group (4.00%) than that in the control group (28.00%), and the difference was statistically significant ( P < 0.05), while only 1 patient in the study group had chronic pain, while 7 patients in the control group had incision ulcer (1 case), chronic pain (2 cases), and internal fixation loosening (4 cases). The difference was statistically significant ( P < 0.05). Conclusion. The cable-pin system for the treatment of an olecranon fracture has the advantages of simple operation, fast fracture healing time, and low incidence of complications, which is a kind of orthopedic internal fixation consumable material in line with biomechanical requirements of the human body.

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“…In most cases, anatomical restoration of distal radial alignment also results in anatomical or near anatomical reduction of the ulnar styloid. 8…”

Section: Distal Ulna Fractures Ulnar Styloid Fracturesmentioning

confidence: 99%

“…Ulnar styloid fixation to stabilize the TFCC can be performed with tension band fixation, screws, or other methods. 8 If the osseous fixation is adequate, then TFCC repair is considered. There are also various techniques noted for repair of the TFCC, either open or arthroscopic.…”

Section: Management Of Persistent Druj Instabilitymentioning

confidence: 99%

See 1 more Smart Citation

Distal Radioulnar Joint, Distal Ulna Injury, and Lunate Facet Considerations in Distal Radius Fractures

Rubio¹

2021

Journal of Orthopaedic Trauma

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Injuries to the distal aspect of the ulna and the distal radioulnar joint (DRUJ) commonly occur concurrently with distal radius fractures. These fractures may also involve the sigmoid notch of the lunate facet of the radius. Each of these structures merits consideration when managing ulnar-sided injuries associated with distal radius fractures. Improper management of distal radioulnar complex injuries may result in limited wrist motion, persistent DRUJ instability, and pain despite successful fracture union. The distal ulna is the keystone of the distal radioulnar articulation. An understanding of the components of the distal radioulnar complex and methods to manage injuries of each of these components contributes to improved functional outcomes by restoring this keystone effect. The classification of distal radioulnar injuries discussed herein provides a framework for understanding the disruption of the ligamentous stabilizers of the DRUJ and identifying residual distal radioulnar instability after fracture fixation. Proper treatment of residual DRUJ instability will restore stability and minimize persistent functional impairment.

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Operative versus non-operative treatment of ulnar styloid process base fractures: a systematic review and meta-analysis

van Rossenberg,

Beeres,

van Heijl

et al. 2024

Eur J Trauma Emerg Surg

0

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Purpose Ulnar styloid process (USP) fractures are present in 40–65% of all distal radius fractures (DRFs). USP base fractures can be associated with distal radioulnar joint (DRUJ) instability and ulnar sided wrist pain and are treated by conservative management and surgical fixation, without consensus. This systematic review and meta-analysis compares operative to non-operative treatment of concomitant ulnar styloid base fractures in patients with distal radius fractures. Methods PubMed/Medline/Embase/CENTRAL databases were searched identifying RCTs and comparative observational studies. Effect estimates were extracted and pooled using random effect models to account for heterogeneity across studies. Results were presented as (standardized) mean differences (SMD or MD) or odds ratios (OR) and corresponding 95% confidence intervals (95%CI). Results Two RCTs (161 patients) and three observational studies (175 patients) were included. Tension band wiring was used for surgically treated USP fractures. Results were comparable across the different study designs and hence pooled across studies. Non-surgically treated patients had better wrist function at 6 months (SMD 0.57, 95%CI 0.30; 0.90, I2 = 0%). After 12 months there was no observed difference (MD 2.31, 95%CI −2.57; 7.19, I2 = 91%). Fewer patients had USP non-unions in the operative group (OR 0.08, 95%CI 0.04; 0.18, I2 = 0%). More patients suffered complications in the operative group (OR 14.3; 95%CI 1.08; 188, I2 = 89%). Conclusion Routinely fixating USP base fractures as standard of care is not indicated. Surgery may be considered in selective cases (e.g. persistent DRUJ instability during ballottement test after fixation of the radius).

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

Cited by 6 publications

References 19 publications

Comparative Analysis of Clinical Effects of the Cable‐Pin System and Kirschner Wire Tension Band (TBW) Internal Fixation in the Treatment of the Olecranon Fracture

Comparative Analysis of Clinical Effects of the Cable‐Pin System and Kirschner Wire Tension Band (TBW) Internal Fixation in the Treatment of the Olecranon Fracture

Distal Radioulnar Joint, Distal Ulna Injury, and Lunate Facet Considerations in Distal Radius Fractures

Operative versus non-operative treatment of ulnar styloid process base fractures: a systematic review and meta-analysis

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