EFFECT OF ASSOCIATED ULNAR STYLOID FRACTURE ON WRIST FUNCTION AFTER DISTAL RADIUS FRACTURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Shuzhen , CHEN Yueping , LIN Zonghan , FAN Qie , CUI Wei , FENG Zhe.

Department of Orthopedics, the Affiliated Ruikang Hospital, Guangxi Traditional Chinese Medical College, Nanning Guangxi, 530011, P.R.China.;

Corresponding author：

Keywords：

Distal radius fracture; Ulnar styloid fracture; Closed reduction; Open reduction; Wrist function

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Objective To evaluate the effect of associated ulnar styloid fracture on wrist function after distal radius fracture by comparing the cl inical data between the cases of distal radius fracture with or without ulnar styloid fractures. Methods The cl inical data of 182 patients with distal radius fracture between February 2005 and May 2010 were retrospectively analyzed, including 75 with ulnar styloid fracture (group A), and 107 without ulnar styloid fracture (group B). There was no significant difference in sex, age, disease duration, and fracture classification between 2 groups (P gt; 0.05). In groups A and B, closed reduction and spl intlet or cast fixation were performed in 42 and 63 cases respectively, and open
reduction and internal fixation in 33 and 44 cases respectively. All ulnar styloid fractures were not treated. Results The
patients were followed up 21 months on average in group A and 20 months on average in group B. All incisions healed by first intention after operation. Ulnar wrist pain occurred in 4 patients (5.3%) of group A and 6 patients (5.6%) of group B, showing no significant difference (χ2=0.063, P=0.802). The fracture heal ing time was (10.9 ± 2.7) weeks in group A and (11.6 ± 2.3) weeks in group B, showing no significant difference (t=1.880, P=0.062). There was no significant difference in the palmar tilt angle, the ulnar incl ination angle, and the radial length between groups A and B when fracture healing (P gt; 0.05). At last follow-up, there was no significant difference in wrist flexion-extension, radial-ulnar deviation, pronation-supination, and grip and pinch strength between 2 groups (P gt; 0.05). According to the Gartland-Werley score in groups A and B, the results were excellent in 24 and 35 cases, good in 43 and 57 cases, fair in 5 and 10 cases, and poor in 3 and 5 cases with execllent and good rate of 89.3% and 86.0%, respectively, showing no significant difference between 2 groups (Z= —0.203, P=0.839). There were significant differences in the above indexes between patients undergoing closed reduction and open reduction in group A (P lt; 0.05). Conclusion Associated ulnar styloid fracture has no obvious effect on the wrist function after distal radius fracture. The anatomical reduction of distal radial fracture is the crucial importance in the treatment of distal radial fracture accompanying ulnar styloid fracture.

Citation： LI Shuzhen,CHEN Yueping,LIN Zonghan,FAN Qie,CUI Wei,FENG Zhe.. EFFECT OF ASSOCIATED ULNAR STYLOID FRACTURE ON WRIST FUNCTION AFTER DISTAL RADIUS FRACTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(6): 666-671. doi: Copy

1.	Abramo A, Kopylov P, Geijer M, et al. Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures: a randomized study of 50 patients. Acta Orthop, 2009, 80(4): 478-485.
2.	Lindau T, Arner M, Hagberg L. Intraarticular lesions in distal fractures of the radius in young adults. A descriptive arthroscopic study in 50 patients. J Hand Surg (Br), 1997, 22(5): 638-643.
3.	Richards RS, Bennett JD, Roth JH, et al. Arthroscopic diagnosis of intra-articular soft tissue injuries associated with distal radial fractures. J Hand Surg (Am), 1997, 22(5): 772-776.
4.	Stoffelen D, De Smet L, Broos P. The importance of the distal radioulnar joint in distal radial fractures. J Hand Surg (Br), 1998, 23(4): 507-511.
5.	Mikic ZD. Treatment of acute injuries of the triangular fibrocartilage complex associated with distal radioulnar joint instability. J Hand Surg (Am), 1995, 20 (2): 319-323.
6.	Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. J Hand Surg (Am), 2000, 25(3): 464-468.
7.	Kazemian GH, Bakhshi H, Lilley M, et al. DRUJ instability after distal radius fracture: a comparison between cases with and without ulnar styloid fracture. Int J Surg, 2011, 9(8): 648-651.
8.	Buijze GA, Ring D. Clinical impact of United versus nonunited fractures of the proximal half of the ulnar styloid following volar plate fixation of the distal radius. J Hand Surg (Am), 2010, 35(2): 223-227.
9.	Kim JK, Yun YH, Kim DJ, et al. Comparison of united and nonunited fractures of the ulnar styloid following volar-plate fixation of distal radius fractures. Injury, 2011, 42(4): 371-375.
10.	Lindau T, Hagberg L, Adlercreutz C, et al. Distal radioulnar instability is an independent worsening factor in distal radial fractures. Clin Orthop Relat Res, 2000, (376): 229-235.
11.	Roysam GS. The distal radio-ulnar joint in Colles’ fractures. J Bone Joint Surg (Br), 1993, 75(1): 58-60.
12.	Sarmiento A, Pratt GW, Berry NC, et al. Colles’ fractures. Functional bracing in supination. J Bone Joint Surg (Am), 1975, 57(3): 311-317.
13.	Gartland JJ Jr, Werley CW. Evaluation of healed Colles’ fractures. J Bone Joint Surg (Am), 1951, 33-A(4): 895-907.
14.	May MM, Lawton JN, Blazar PE. Ulnar styloid fractures associated with distal radius fractures: incidence and implications for distal radioulnar joint instability. J Hand Surg (Am), 2002, 27(6): 965-971.
15.	Zenke Y, Sakai A, Oshige T, et al. The effect of an associated ulnar styloid fracture on the outcome after fixation of a fracture of the distal radius. J Bone Joint Surg (Br), 2009, 91(1): 102-107.
16.	Kim JK, Koh YD, Do NH. Should an ulnar styloid fracture be fixed following volar plate fixation of a distal radial fracture? J Bone Joint Surg (Am), 2010, 92(1): 1-6.
17.	May MM, Lawton JN, Blazar PE. Ulnar styloid fractures associated with distal radius fractures: incidence and implications for distal radioulnar joint instability. J Hand Surg (Am), 2002, 27(6): 965-971.

1. Abramo A, Kopylov P, Geijer M, et al. Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures: a randomized study of 50 patients. Acta Orthop, 2009, 80(4): 478-485.
2. Lindau T, Arner M, Hagberg L. Intraarticular lesions in distal fractures of the radius in young adults. A descriptive arthroscopic study in 50 patients. J Hand Surg (Br), 1997, 22(5): 638-643.
3. Richards RS, Bennett JD, Roth JH, et al. Arthroscopic diagnosis of intra-articular soft tissue injuries associated with distal radial fractures. J Hand Surg (Am), 1997, 22(5): 772-776.
4. Stoffelen D, De Smet L, Broos P. The importance of the distal radioulnar joint in distal radial fractures. J Hand Surg (Br), 1998, 23(4): 507-511.
5. Mikic ZD. Treatment of acute injuries of the triangular fibrocartilage complex associated with distal radioulnar joint instability. J Hand Surg (Am), 1995, 20 (2): 319-323.
6. Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. J Hand Surg (Am), 2000, 25(3): 464-468.
7. Kazemian GH, Bakhshi H, Lilley M, et al. DRUJ instability after distal radius fracture: a comparison between cases with and without ulnar styloid fracture. Int J Surg, 2011, 9(8): 648-651.
8. Buijze GA, Ring D. Clinical impact of United versus nonunited fractures of the proximal half of the ulnar styloid following volar plate fixation of the distal radius. J Hand Surg (Am), 2010, 35(2): 223-227.
9. Kim JK, Yun YH, Kim DJ, et al. Comparison of united and nonunited fractures of the ulnar styloid following volar-plate fixation of distal radius fractures. Injury, 2011, 42(4): 371-375.
10. Lindau T, Hagberg L, Adlercreutz C, et al. Distal radioulnar instability is an independent worsening factor in distal radial fractures. Clin Orthop Relat Res, 2000, (376): 229-235.
11. Roysam GS. The distal radio-ulnar joint in Colles’ fractures. J Bone Joint Surg (Br), 1993, 75(1): 58-60.
12. Sarmiento A, Pratt GW, Berry NC, et al. Colles’ fractures. Functional bracing in supination. J Bone Joint Surg (Am), 1975, 57(3): 311-317.
13. Gartland JJ Jr, Werley CW. Evaluation of healed Colles’ fractures. J Bone Joint Surg (Am), 1951, 33-A(4): 895-907.
14. May MM, Lawton JN, Blazar PE. Ulnar styloid fractures associated with distal radius fractures: incidence and implications for distal radioulnar joint instability. J Hand Surg (Am), 2002, 27(6): 965-971.
15. Zenke Y, Sakai A, Oshige T, et al. The effect of an associated ulnar styloid fracture on the outcome after fixation of a fracture of the distal radius. J Bone Joint Surg (Br), 2009, 91(1): 102-107.
16. Kim JK, Koh YD, Do NH. Should an ulnar styloid fracture be fixed following volar plate fixation of a distal radial fracture? J Bone Joint Surg (Am), 2010, 92(1): 1-6.
17. May MM, Lawton JN, Blazar PE. Ulnar styloid fractures associated with distal radius fractures: incidence and implications for distal radioulnar joint instability. J Hand Surg (Am), 2002, 27(6): 965-971.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECT OF ASSOCIATED ULNAR STYLOID FRACTURE ON WRIST FUNCTION AFTER DISTAL RADIUS FRACTURE

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