What's the best surgical repair technique of an ulnar styloid fracture? A biomechanical comparison of different techniques

Maniglio, Mauro; Fraipont, William; Flueckiger, Remy; Zumstein, Matthias A.; McGarry, Michelle H.; Lee, Thay Q.

doi:10.1016/j.injury.2021.06.026

Cited by 4 publications

(1 citation statement)

References 26 publications

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“…Specimens were tested in a custom system used also in prior studies (Maniglio et al, 2021a(Maniglio et al, , 2021b(Maniglio et al, , 2021c (Figures 1 and S1). The forearm was mounted using the PVC potting to position the humerus in a static, horizontal position.…”

Section: Testing Setupmentioning

confidence: 99%

Residual stability of the distal radioulnar joint following ulnar styloid fracture: influence of the remnant distal radioulnar ligaments

Maniglio

Park

Kuenzler

et al. 2022

J Hand Surg Eur Vol

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Clinical studies suggest that even untreated basal ulnar styloid fractures may not affect patient outcomes. This may be due to the remaining parts of the distal radioulnar ligament still attached providing sufficient residual stability of the distal radioulnar joint. We tested this hypothesis in a biomechanical cadaveric model. Dorsopalmar translation of the distal radioulnar joint and forearm rotation were measured. Seventeen specimens were tested after a simulated ulnar styloid fracture including the fovea, followed by transection of the remaining palmar ( n = 9) or dorsal ( n = 8) portions of the distal radioulnar ligament and finally with all remnants transected. Rotation and translation both increased significantly after the final transection compared with the foveal fracture. The increase in translation was larger after transection of the dorsal remnants. We conclude that in an ulnar styloid fracture including the fovea, some ligament components are still attached to the ulnar head, giving residual stability to the distal radioulnar joint.

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Section: Testing Setupmentioning

confidence: 99%

Residual stability of the distal radioulnar joint following ulnar styloid fracture: influence of the remnant distal radioulnar ligaments

Maniglio

Park

Kuenzler

et al. 2022

J Hand Surg Eur Vol

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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

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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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Comparative analysis of tension band wiring and hook plate fixation in ulnar styloid fractures: a focus on fracture type

Kang,

Lee,

2024

Arch Orthop Trauma Surg

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What's the best surgical repair technique of an ulnar styloid fracture? A biomechanical comparison of different techniques

Cited by 4 publications

References 26 publications

Residual stability of the distal radioulnar joint following ulnar styloid fracture: influence of the remnant distal radioulnar ligaments

Residual stability of the distal radioulnar joint following ulnar styloid fracture: influence of the remnant distal radioulnar ligaments

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

Comparative analysis of tension band wiring and hook plate fixation in ulnar styloid fractures: a focus on fracture type

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