The Influence of Non-union of the Ulnar Styloid on Pain, Wrist Function and Instability after Distal Radius Fracture

Abstract

The influence of non-union on the outcome of distal radius fractures is debated. We tested the null hypothesis that there is no difference in pain, wrist function, or instability between patients with union or non-union of an ulnar styloid base fracture after operative treatment of a fracture of the distal radius. Eighteen adults with an ulnar styloid base non-union were compared to 16 patients with union of an ulnar styloid base fracture with a mean post-operative follow-up of 30 months. None of the patients had distal radioulnar joint instability, there were no significant differences in pain, complications, or function, and patients with nonunion had significantly greater grip strength. Ulnar styloid nonunion is not associated with pain, instability, or diminished function after fracture of the distal radius.

Keywords

Distal radius fracture - Ulnar styloid fracture - Non-union - Wrist fracture

• References

• 1 Abid A, Accadbled F, Kany J et al Ulnar styloid fracture in children: a retrospective study of 46 cases. J Pediatr Orthop B 2008; 17: 15-19
• 2 af Ekenstam F, Jakobsson OP, Wadin K. Repair of the triangular ligament in Colles’ fracture: no effect in a prospective randomized study. Acta Orthop Scand 1989; 60: 393-396
• 3 Amadio PC, Berquist TH, Smith DK et al Scaphoid malunion. J Hand Surg Am 1989; 14 ((4)) 679-687
• 4 Buijze G, 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
• 5 Gartland Jr JJ, Werley CW. Evaluation of healed Colles’ fractures. J Bone Joint Surg Am 1981; 33: 895-907
• 6 Hauck RM, Skahen III J, Palmer AK. Classification and treatment of ulnar styloid non-union. J Hand Surg 1996; 21A: 418-422
• 7 Kaukonen JP, Karahuarju EO, Porras M et al Functional recovery after fractures of the distal forearm. Analysis of radiographic and other factors affecting the outcome. Ann Chir Gynaecol 1988; 77: 27-31
• 8 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
• 9 Lindau T, Arner M, Hagberg I. Intraarticular lesions in distal fractures of the radius in young adults. A descriptive arthroscopic study in 50 patients. J Hand Surg Br 1997; 5: 638-643
• 10 Melone CP, Nathan R. Traumatic disruption of the triangular fibrocartilage complex. Clin Orthop 1992; 275: 65-73
• 11 Müller ME, Allgöwer M, Schneider R et al Manual of internal fixation. 1991. 3rd edn Springer; New York:
• 12 Oskarsson GV, Asser P, Hjall A. Do we underestimate the predictive value of the ulnar styloid affection in Colles fractures?. Arch Orthop Trauma Surg 1997; 116: 341-344
• 13 Souer JS, Ring D, Matschke S et al Effect of an unrepaired fracture of the ulnar styloid base on outcome after plate-and-screw fixation of a distal radial fracture. J Bone Joint Surg Am 2009; 91 ((4)) 830-838
• 14 Stoffelen D, de Smet L, Broos P. The importance of the distal radioulnar joint in distal radial fractures. J Hand Surg 1998; 23B: 507-511
• 15 Tsukazaki T, Iwasaki K. Ulnar wrist pain after Colles’ fracture. Acta Orthop Scand 1993; 64: 462-464
• 16 Villar RN, Marsh D, Rushton N et al Three years after Colles’ fracture: a prospective review. J Bone Joint Surg 1987; 69B: 635-638
• 17 Zenke Y, Sakai A, Oshige T. 2009; The effect of an associated ulnar styloid fracture on the outcome after fixation of a fractures of the distal radius. J Bone Joint Surg Br et al 91 ((1)) 102-107
• 18 Zimmermann R, Rudisch A, Fritz D et al MR imaging for the evaluation of accompanying injuries in cases of distal forearm fractures in children and adolescents [in German]. Handchir Mikrochir Plast Chir 2007; 39 ((1)) 60-67