Influence of ulnar styloid fracture with concurrent extra-articulardistal radius fracture on forearm rotations

Abstract

Introduction: This study was conducted to evaluate the relation between extra articular distal radius fracture associated with and without ulnar styloid fracture and the rotational movements of wrist and forearm. Materials and Methods: This retrospective study was performed on 86 unilateral, extra articular distal radius fracture, treated conservatively. Associated ulnar styloid fracture was present in 42 (48.8%) group Aand 44 (51.2%) with intact ulnar styloid group B. Men were 54 (62.8%) and women 32 (37.2%). Distal radius fracture involving right, dominant side were 56 (65.1%). All patients were treated by one surgeon with close reduction under anaesthesia with plaster immobilisation. Long arm cast was applied with forearm in supination wrist in ulnar volar flexion and after 2 weeks changed to below elbow cast with wrist in neutral rotation. Results: The mean limitation of supination was 7.82 ± 5.19 for group 1 (intact styloid) and 23.82±14.41 for group 2 (fractured styloid). The mean limitation of pronation was 4.72 ± 3.68 for group 1 (intact styloid) and 3.29 ± 2.79 for group 2 (fractured styloid). The difference between the two groups was statistically significant regarding the limitation of supination, but not about the 0 0 0 limitation of pronation. The average pronation deformity was 120 (range 60 to 190 ) in patients with dorsal malunion and 110 0 (range 50 to 210) in volar malunion. The supination deformity averaged at about 80° (range 40° to 140°) in dorsal and 120 0 0 (range 80 to 170 ) in volarly angulated distal radius malunion. Conclusion: The association of extra articular distal radius fracture with fracture ulnar styloid at two year follow up causes restriction of supination and pronation of forearm