Treatment of symptomatic non-unions of the base of the ulnar styloid with plate osteosynthesis

Abstract

Therapeutic IV.

Early and late fixation of ulnar styloid base fractures yields different outcomes

“…The latter implies higher-energy trauma with a potential risk of distal radioulnar ligament tear and may serve as a marker for injury severity [ 17 ]. Articles favoring conservative treatment primarily emphasized successful surgical fixation in distal radius fractures, while the injury severity in ulnar styloid fractures per se and the resulting symptoms were generally underestimated and inadequately treated [ 12 ]. It is not our purpose to recommend that all ulnar styloid fractures need to be surgically treated.…”

“…Ulnar styloid fractures have been traditionally discussed with distal radius fractures and generally treated conservatively [ 18 ]. Only a handful of articles have reported surgical management and outcomes of ulnar styloid fractures [ 1 , 12 , 19 ]. A current prospective study reported symptomatic nonunion that was successfully treated with plating osteosynthesis [ 12 ].…”

“…Only a handful of articles have reported surgical management and outcomes of ulnar styloid fractures [ 1 , 12 , 19 ]. A current prospective study reported symptomatic nonunion that was successfully treated with plating osteosynthesis [ 12 ]. This study only enrolled patients with chronic injury occurring more than 6 months prior, and the sample size was small.…”

“…Our study included 28 patients, and surgical outcomes and complications were compared between acute fracture and chronic injury. Since we used simple pins and wire to fix styloid fractures, and suture anchors for TFCC repair when necessary, the overall complication rate was higher than in a prior study using plating osteosynthesis [ 12 ]. There were more implant-related complications, especially in the chronic group.…”

“…Given the rising concern about the presence of an ulnar styloid with residual ulnocarpal complains [ 7 ], current studies still questioned the potential advantages of surgical fixation of these fractures [ 8 – 10 ]. Updated reports regarding sequelae of untreated distal ulnar fractures were either confined to cadaver studies [ 11 ] or had a small sample size [ 12 ]. The purpose of this study was to discuss the presentation in a case series of ulnar styloid fractures and to compare the treatment outcomes following early surgical intervention or late management.…”