Will the untreated ulnar styloid fracture influence the outcome of unstable distal radial fracture treated with external fixation when the distal radioulnar joint is stable

Chen, Yixin; Zheng, Xi; H, Shi; Wangyang, Yufan; Han, Yuan; Xie, Xiao-xiao; Li, Dong-ya; Wang, Changjun; Qiu, Xusheng

doi:10.1186/1471-2474-14-186

Cited by 23 publications

(26 citation statements)

References 39 publications

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“…Wrist pain was reported to be statistically significantly worse at the final follow-up in patients with an associated fracture of the ulnar styloid affecting the DRUJ in two of the included studies. 18,47 A previous study 16 did not report any statistically significant difference, among patients with DRF, between patients with healed USF, and patients with nonunion of USF. Pain in the wrist mainly occurs on the ulnar side and can be explained by concurrent injuries to the TFCC and soft tissues.…”

Section: Discussionmentioning

confidence: 87%

“…They included a randomized controlled trial (RCT), 46 case-control study, 21 and four comparative cohort observational studies (3x prospective and 1x retrospective). [17][18][19]47 Altogether, the total number of patients with DRF included in the review was 796 and the number of wrists with DRF was 806; 444 (55%) of DRF had an associated USF (►Table 3).…”

Section: Outcome Measuresmentioning

confidence: 99%

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Effects of Ulnar Styloid Fractures on Unstable Distal Radius Fracture Outcomes: A Systematic Review of Comparative Studies

et al. 2017

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In this literature review, functional outcomes such as Disability of Arm, Shoulder and Hand (DASH) score and the visual analog scale (VAS) of pain along with clinical outcomes such as range of movement and grip strength of treated distal radius fractures (DRF) accompanied with ulnar styloid fractures (USF) will be compared with those with isolated DRF. We analyzed articles from MEDLINE, Embase, and CINAHL that met our predetermined inclusion and exclusion criteria as per the Preferred Reporting Items for Systematic Reviews and Meta-analysis statements. This resulted in the identification of 464 articles with 18 potentially eligible studies of which 6 were included at the full-text screening stage. The primary outcomes were wrist pain, range of motion, functional outcome and satisfaction, such as VAS, and the DASH questionnaire along with radiological assessment and incidence of complications. These studies involved 796 participants with DRF and 806 wrists with DRF; 444 (55%) of DRF had an associated USF. Three studies did not report any statistically significant difference in DASH scores between the DRF patients with or without USF. Two studies reported worse DASH scores in the group with associated USF. Wrist pain was reported to be statistically significantly worse in patients with associated USF in two studies. Grip strength did not exhibit a statistically significant difference in any groups in four studies. On assessing the range of motion of the wrist and forearm, only one study reported a statistically significant difference in flexion at 2 years follow-up, with less flexion in patients with USF. This review suggests that there is no significant correlation between a USF and the functional and clinical outcomes of DRF treatment, albeit wrist pain and less flexion were reported in some studies to be associated with USF. There is a need for more robust evidence from large randomized controlled trials to specifically look at the effects of fixation versus nonfixation of USF on DRF, or large prospective cohort studies assessing DRF with and without USF, with a minimum of 12 months follow-up. Level II-therapeutic.

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Section: Discussionmentioning

confidence: 87%

Section: Outcome Measuresmentioning

confidence: 99%

Effects of Ulnar Styloid Fractures on Unstable Distal Radius Fracture Outcomes: A Systematic Review of Comparative Studies

et al. 2017

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“…[7] On the other hand, many studies didn't show this and they didn't find any relation between ulnar styloid status and the final result. [8], [9], [10], [11] But it should be considered that there is no uniformity among these studies and some of them focused on displaced fractures fixed with plate and screws, [8], [9] another one were performed on fractures treated by pinning. [7] and the other focused on the fractures, which were fixed with external fixation.…”

Section: Discussionmentioning

confidence: 99%

“…[7] and the other focused on the fractures, which were fixed with external fixation. [11] Again variables of the studies were different too, in a way that the reader should refer to the original articles. In fact, in the past surgery has been considered for nonunion of styloid.…”

Section: Discussionmentioning

confidence: 99%

Ulnar Wrist Pain in Distal End Radius Fractures Prevented by Prophylactic Corticosteroid Injection

Ghodke¹,

Vieira²,

Vanjari³

et al. 2016

jemds

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BACKGROUND Common complication of Distal Radius fracture is ulnar sided pain. The simplest method for decreasing pain is corticosteroid injection. The present study was designed to assess the effect of corticosteroid injection in the prevention of ulnar sided wrist pain. MATERIALS AND METHODS In this clinical trial patients with distal radius fractures scheduled for closed reduction and percutaneous pin fixation were divided into control and corticosteroid groups. In the corticosteroid group, the patient received a single Triamcinolone Acetate injection in the dorsoulnar side of the wrist before reduction, while the control group received placebo. The patients were to be followed for at least 6 months. RESULTS Eighty two patients were followed for 6 months. At the end of the 3 months follow-up, the difference between the two groups about the number of individuals without ulnar sided wrist pain was statistically significant (P=0.038), so that less patients in the control group were painless, while this was not the case in the 6 months follow-up (P= 0.507), but in the both time frames the mean grip power, visual analogue pain score and the Disabilities of the Arm, Shoulder and Hand (DASH) score showed statistically significant difference between the two groups, so that the corticosteroid groups demonstrated greater power grip and less scores in pain and DASH (P<0.05). CONCLUSION Based on the findings of the present study it seems that prophylactic corticosteroid injection will be associated with a decrease in the severity of wrist pain in patients with acute distal radius fractures. With regard to the decrease in the number of painless individuals, it seems that the decrease is not persistent. Overall, the need for a study with longer follow-up is obvious.

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“… 8 On the other hand, many studies didn’t show this and they didn’t find any relation between ulnar styloid status and the final result. 9 10 11 12 But it should be considered that there is no uniformity among these studies and some of them focused on displaced fractures fixed with plate and screws, 9 10 another one were performed on fractures treated by pinning 8 and the other focused on the fractures, which were fixed with external fixation. 12 Again variables of the studies were different too, in a way that the reader should refer to the original articles.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic corticosteroid injection in ulnar wrist pain in distal radius fracture

Saied

Heshmati

Sadeghifar

et al. 2015

IJOO

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Background:Ulnar sided wrist pain is one of the most common complications of distal radius fractures. The simplest method for decreasing pain for this affliction is corticosteroid injection. The present study was designed to assess the effect of corticosteroid injection in the prevention of ulnar sided wrist pain.Materials and Methods:In this clinical trial patients with distal radius fractures scheduled for closed reduction and percutaneous pin fixation were divided into control and corticosteroid groups. In the corticosteroid group, the patient received a single betamethasone injection in the dorsoulnar side of the wrist before reduction, while the control group received placebo. The patients were to be followed for at least 6 months.Results:82 patients were followed for 6 months. At the end of the 3 months followup the difference between the two groups about the number of individuals without ulnar sided wrist pain was statistically significant (P = 0.038), so that less patients in the control group were painless, while this was not the case in the 6 months followup (P = 0.507), but in the both time frames the mean grip power, visual analog pain score and the disabilities of the arm, shoulder and hand (DASH) score showed statistically significant difference between the two groups, so that the corticosteroid groups demonstrated greater power grip and less scores in pain and DASH (P < 0.05).Conclusion:Based on the findings of the present study it seems that prophylactic corticosteroid injection will be associated with a decrease in the severity of wrist pain in patients with acute distal radius fractures. With regard to the decrease in the number of painless individuals, it seems that the decrease is not persistent. Overall the need for a study with longer followup is obvious.

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Will the untreated ulnar styloid fracture influence the outcome of unstable distal radial fracture treated with external fixation when the distal radioulnar joint is stable

Cited by 23 publications

References 39 publications

Effects of Ulnar Styloid Fractures on Unstable Distal Radius Fracture Outcomes: A Systematic Review of Comparative Studies

Effects of Ulnar Styloid Fractures on Unstable Distal Radius Fracture Outcomes: A Systematic Review of Comparative Studies

Ulnar Wrist Pain in Distal End Radius Fractures Prevented by Prophylactic Corticosteroid Injection

Prophylactic corticosteroid injection in ulnar wrist pain in distal radius fracture

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