Effect Of Ulnar Styloid Fracture Research Articles

The Effect of Ulnar Styloid Fractures on Patient-Reported Outcomes After Surgically Treated Distal Radial Fractures.

Background:Ulnar styloid fractures (USFs) are often associated with distal radial fractures (DRFs). When unstable DRFs are treated surgically, any associated USF is most commonly left untreated. The purpose of this study was to evaluate the effect of a concomitant USF on outcome after surgical stabilization of a DRF.Methods:Data from 2 randomized controlled trials on the treatment of unstable DRFs were pooled. The effect of a USF on the QuickDASH, EQ-5D, pain, and range of motion at 2 years was evaluated.Results:Two hundred and eighty-one patients were included; 177 (63%) had an associated, untreated USF. An unadjusted analysis demonstrated no significant difference in functional or patient-reported outcome measures (PROMs) at 2 years between patients with or without a concomitant USF. When controlling for confounding factors, the presence of a USF did not predict change in any of the PROMs from baseline to 2 years. A concomitant USF also did not predict change in grip strength or range of motion, except for a small effect on extension (−4.1°; 95% confidence interval, −7.5° to −0.8°; p = 0.02), which probably does not have clinical relevance.Conclusions:A USF in combination with a DRF does not affect PROMs, range of motion, or grip strength. We recommend that concomitant USFs be left untreated when treating a DRF with surgical fixation.Level of Evidence:Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.

Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture.

This study aims to investigate the effect of accompanying ulnar styloid fracture (USF) on clinical outcomes and hand-wrist muscle strength in conservatively treated active patients after displaced distal radius fracture (DRF). The retrospective study, which was conducted November 2012 and September 2016, included 56 patients (34 males, 22 females; mean age 28.8 years; range 20 to 40 years) with displaced DRF treated with closed reduction and casting. Patients were divided into three groups according to ulnar styloid status as group A (intact ulnar styloid), group B (USF non-union), and group C (healed USF). Grip strength, quick-disabilities of the arm, shoulder and hand (DASH) score, and joint range of motions were evaluated; the results were combined with measurements of isokinetic muscle strengths of hand-wrist region. Magnetic resonance imaging was performed to evaluate the accompaniment of distal radioulnar joint injury and triangular fibrocartilage complex (TFCC) lesion. There were no significant differences between the groups regarding joint range of motion, grip strength, and quick-DASH scores. However, the peak torque and total work of supination was better in group A compared to group B (p=0.008 and p=0.006, respectively). According to the magnetic resonance imaging findings, of the 10 patients with detected TFCC lesion, four were in group C, five in group B, and one was in group A. Results of this study suggest that USF should not be the focus of attention during initial treatment of DRF and surgical intervention might be considered in case of an accompanying TFCC lesion.

Ignore fractures of the ulnar styloid in distal radius fractures

Fractures of the ulnar styloid frequently accompany fractures of the distal radius, however, there is no conclusive evidence whether it influences the final outcome of the treatment. The majority of studies show no negative effect of ulnar styloid fractures on final outcome, when the fracture of the distal radius is fixed, preferably by a locking plate [1,2]. Some authors, however, report on frequent non-unions of the ulnar styloid, distal radio-ulnar joint (DRUJ) instabilities, triangular fibrocartilage complex (TFCC) tears, and other complications which may cause ulnar wrist pain, reduced mobility and power of the hand [3,4]. No studies are available that address this issue for K-wire fixation of the distal radius fractures.

Effect of ulnar styloid fracture on functional outcome of Colle's fractures: a comparative analysis of two groups

Background: The negative impact of ulnar sided injuries on distal radius fractures has opened another field of research and is gaining more attention. The aim of our study is to assess the impact of ulnar styloid process fracture on functional outcome of distal radius fractures managed conservatively. Methods: Radiological and Medical records of 150 patients of distal radius with and without styloid process fractures were retrospectively reviewed. Fractures were classified as per Frykman’s classification and patients were assessed for pain, grip and range of motion in addition to other parameters in Mayo’s wrist score. The instability at distal radioulnar joint was evaluated and compared in two groups. Results: There was a measurable difference in motion, strength, pain, or functional scores between the two groups. Mean mayo score at final follow up in Group I was 90±5 and in Group II was 80±4 and the difference was statistically significant (P value <0.05). DRUJ instability was noted in 20 % of patients in Group II and most of them were symptomatic. Conclusions: We conclude that presence of a fracture of ulnar styloid process with distal radius fracture results in a weak and painful wrist in a significant number of patients. They should be dealt more vigorously and managed effectively to prevent disabling distal radioulnar joint instability.

The Effect of Ulnar Styloid Fractures on Patient-Rated Outcomes After Volar Locking Plating of Distal Radius Fractures

The Effect of Ulnar Styloid Fractures on Patient-Rated Outcomes After Volar Locking Plating of Distal Radius Fractures

The Effect of Ulnar Styloid Fractures on Patient-Rated Outcomes After Volar Locking Plating of Distal Radius Fractures

Ulnar styloid fractures commonly occur with distal radius fractures (DRFs). Ulnar styloid fractures that involve the insertion of the radioulnar ligaments can cause distal radioulnar joint (DRUJ) instability, and the literature suggests that these fractures should be treated with open reduction internal fixation (ORIF). However, in the absence of DRUJ instability, the effects of ulnar styloid fractures are unknown. The purpose of this study is to evaluate the outcome of ulnar styloid fractures without DRUJ instability on patient-rated outcomes after DRF ORIF. Between 2003 and 2008, a cohort of DRF patients treated with volar plating was enrolled. Patients with DRUJ instability treated at the time of distal radius ORIF were excluded. Radiographs were evaluated to identify and characterize ulnar styloid fractures. Patient-rated outcomes were measured at 6 weeks, 3 months, 6 months, and 12 months postoperatively using the Michigan Hand Outcomes Questionnaire (MHQ). Regression analysis was performed to determine whether the presence of an ulnar styloid fracture, the size or displacement of the fracture, or the healing status of the fracture was predictive of MHQ scores. One-hundred and forty-four patients were enrolled; 88 patients had ulnar styloid fractures. During the collection period, DRUJ instability was found intraoperatively in 3 patients; these patients had ulnar styloid ORIF and were not enrolled. The 144 patients with a stable DRUJ after DRF ORIF maintained DRUJ stability after surgery. In these patients, the presence of an ulnar styloid fracture did not affect MHQ scores. Furthermore, the size of the ulnar styloid fracture, the degree of displacement, and the healing status of the ulnar styloid did not affect MHQ scores. In patients with a stable DRUJ after DRF ORIF ulnar styloid fractures did not affect subjective outcomes as measured by the MHQ. Prognostic III.

Commentary: The Effect of Ulnar Styloid Fractures on Patient-Rated Outcomes After Volar Locking Plating of Distal Radius Fractures

Commentary: The Effect of Ulnar Styloid Fractures on Patient-Rated Outcomes After Volar Locking Plating of Distal Radius Fractures

The Effect of Ulnar Styloid Fractures on Patient-rated Outcomes after Volar Locking Plating of Distal Radius Fractures: Level 2 Evidence

The Effect of Ulnar Styloid Fractures on Patient-rated Outcomes after Volar Locking Plating of Distal Radius Fractures: Level 2 Evidence

Cadaveric Biomechanical Analysis of the Distal Radioulnar Joint: Influence of Wrist Isolation on Accurate Measurement and the Effect of Ulnar Styloid Fracture on Stability

Cadaveric Biomechanical Analysis of the Distal Radioulnar Joint: Influence of Wrist Isolation on Accurate Measurement and the Effect of Ulnar Styloid Fracture on Stability

Cadaveric Biomechanical Analysis of the Distal Radioulnar Joint: Influence of Wrist Isolation on Accurate Measurement and the Effect of Ulnar Styloid Fracture on Stability

Distal radioulnar joint (DRUJ) instability can be tested using biomechanical cadaveric models, but inadequate isolation of the DRUJ during instability testing may introduce measurement error. The first goal of this investigation was to develop an effective model for isolating the DRUJ during biomechanical cadaveric testing. The second goal was to use this model to measure the effect of ulnar styloid fracture and subsequent repair on DRUJ kinematics in cadaveric specimens. Five fresh cadaveric arms were tested using a Biodex System 3 device. The humerus was clamped firmly, the forearm rotated freely, and the hand/carpus was attached to the Biodex device. Three methods of DRUJ isolation were tested. In method 1, the specimen was firmly clamped at the midshaft humerus and the hand/carpus was clamped. In method 2, the distal radius was additionally fixed to the carpal clamp to reduce carpal motion. In method 3, proximal fixation of the olecranon to an elbow rest was added. Testing was done before ulnar styloid osteotomy (group 1), after osteotomy through dorsal capsulotomy (group 2), and after styloid fragment repair with a screw (group 3). Twelve pronation-supination cycles were performed while work of rotation, maximum pronation torque, and maximum supination torque for each method and group were recorded. Analysis of clamping methods showed work of rotation, maximum pronation torque, and maximum supination torque for method 3 were greater than those for methods 1 and 2. Analysis of groups showed the following statistically significant trends for work of rotation: group 1 >>> group 3 > group 2. Maximum supination torque similarly showed statistically significant differences: group 1 >>> group 3 > group 2. Maximum pronation torque showed a similar trend: group 1 >>> group 3 > group 2. However, in contrast with work of rotation and maximum supination torque, group 3 maximum pronation torque was not statistically different from that of group 2. Increased work of rotation represents decreased joint laxity. Maximum supination torque and maximum pronation torque assess soft tissue restraints at joint end points. Method 3 showed the greatest values in these variables, indicating reduced elbow and carpal motion and better DRUJ isolation. Work of rotation and maximum supination torque in group 3 were increased from those of group 2 but not restored to group 1 values. Styloid fixation restores some soft tissue tension but laxity persists. Maximum pronation torque in group 3 was not increased significantly from that of group 2, perhaps from dorsal capsulotomy causing soft tissue injury and laxity not corrected with fixation. The influence of ulnar styloid fracture on dynamic DRUJ kinematics can be demonstrated in this model.