[Surgical treatment of the ulnar styloid process using an angle-stable hook plate in fractures and symptomatic nonunions].

Abstract

Anatomical reduction of dislocated fractures using an angle-stable hook plate. Surgical revision of symptomatic nonunions with the aim of bone regeneration. Dislocated fractures of the ulnar styloid process with involvement of the ulnar fovea. Combined fractures with instability of the distal radioulnar joint and symptomatic nonunions. Undisplaced fractures of the ulnar styloid process and asymptomatic nonunions. Dorsoradial access to the distal ulna between the 6th extensor tendon compartment and the tendon of the flexor carpi ulnaris muscle. Exposition of the fracture/nonunion. In case of nonunions, excision and freshening of the fracture ends. Reduction is carried out using the hooks of the plate, if necessary additional attachment of autologous cancellous bone in case of nonunions. Fixation of the plate over the gliding hole and subsequent filling of the angular stable screw holes. Depending on the accompanying injury, immobilization in aforearm plaster splint for 1-2weeks. Active movement exercises of the fingers from postoperative day1, if necessary lymph drainage. After bone development, load build-up under ergotherapy guidance. Bony healing was achieved in 100% of our cases. The surgical treatment of symptomatic nonunions as well as dislocated fractures of the ulnar styloid process using anangle-stable hook plate has proven to be successful.