Functional Outcome of Conservatively Managed Ulnar Styloid Fracture on Wrist Function
DOI:
https://doi.org/10.70749/ijbr.v3i5.3028Keywords:
Ulnar Styloid Fracture, Wrist Function, Distal Radius Injuries, Distal Radioulnar Joint.Abstract
Objective: This study aims to evaluate the functional outcome of conservatively managed ulnar styloid fractures and their effect on wrist function. Ulnar styloid fractures are commonly associated with distal radius injuries and may influence distal radioulnar joint (DRUJ) stability, potentially affecting overall wrist mechanics. Methods: A retrospective observational study was conducted including 80 patients with ulnar styloid fractures managed conservatively using immobilization followed by rehabilitation at Department of Orthopedic Surgery, Combined Military Hospital, Rawalpindi. Patients were assessed at 6 weeks and 12 weeks follow-up. Functional outcomes were evaluated using the Patient-Rated Wrist Evaluation (PRWE) score, range of motion (ROM), and grip strength. Additional clinical parameters such as pain, joint stability, and complications were also recorded. Results: The majority of patients demonstrated satisfactory functional recovery with significant improvement over time. The mean PRWE score improved from 49.8 ± 10.2 at 6 months to 41.2 ± 9.5 at 1 year (p < 0.05), indicating reduced pain and disability. Wrist ROM, particularly flexion and extension, showed statistically significant improvement (p < 0.05), while radial and ulnar deviation improved but were not statistically significant. Grip strength increased gradually but did not reach full recovery compared to the contralateral side. A small proportion of patients reported persistent mild pain and occasional instability. Conclusion: Conservatively managed ulnar styloid fractures generally result in favorable functional outcomes with significant improvement in pain and wrist mobility over time. However, some patients may experience residual symptoms, particularly reduced grip strength and mild discomfort. These findings highlight the importance of proper rehabilitation and follow-up to optimize wrist function after conservative treatment.
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References
1. Court-Brown CM, Heckman JD, McQueen MM, Ricci WM, Tornetta P. Rockwood and Green’s Fractures in Adults. 9th ed. Philadelphia: Wolters Kluwer; 2019.
2. Azar, F. M., Canale, S. T., & Beaty, J. H. (2020). Campbell's Operative Orthopaedics, E-Book. Elsevier Health Sciences.
3. Moore, K. L., Dalley, A. F., & Agur, A. M. (1985). Clinically oriented anatomy. ed. Baltimore: Williams and Wilkins.
4. Kapandji, I. A. (2019). The Physiology of the Joints: Upper Limb. 6th ed. Edinburgh: Churchill Livingstone.
5. Palmer, A. K. (1989). Triangular fibrocartilage complex lesions: A classification. The Journal of Hand Surgery, 14(4), 594-606. https://doi.org/10.1016/0363-5023(89)90174-3
6. May, M. M., Lawton, J. N., & Blazar, P. E. (2002). Ulnar styloid fractures associated with distal radius fractures: Incidence and implications for distal radioulnar joint instability. The Journal of Hand Surgery, 27(6), 965-971. https://doi.org/10.1053/jhsu.2002.36525
7. Lindau, T., Adlercreutz, C., & Aspenberg, P. (2000). Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. The Journal of Hand Surgery, 25(3), 464-468. https://doi.org/10.1053/jhsu.2000.6467
8. Ekenstam, F. A., & Hagert, C. G. (1985). Anatomical studies on the geometry and stability of the distal radio ulnar joint. Scandinavian Journal of Plastic and Reconstructive Surgery, 19(1), 17-25. https://doi.org/10.3109/02844318509052861
9. MacDermid, J. C. (1996). Development of a scale for patient rating of wrist pain and disability. Journal of Hand Therapy, 9(2), 178-183. https://doi.org/10.1016/s0894-1130(96)80076-7
10. Hudak, P. L., Amadio, P. C., Bombardier, C., Beaton, D., Cole, D., Davis, A., Hawker, G., Katz, J. N., Makela, M., Marx, R. G., Punnett, L., & Wright, J. (1996). Development of an upper extremity outcome measure: The DASH (disabilities of the arm, shoulder, and head). American Journal of Industrial Medicine, 29(6), 602-608. https://doi.org/10.1002/(sici)1097-0274(199606)29:6<602::aid-ajim4>3.0.co;2-l
11. Einhorn, T. A. (2005). The science of fracture healing. Journal of Orthopaedic Trauma, 19(Supplement), S4-S6. https://doi.org/10.1097/00005131-200511101-00002
12. Jupiter, J. B., & Fernandez, D. L. (1997). Comparative classification for fractures of the distal end of the radius. The Journal of Hand Surgery, 22(4), 563-571. https://doi.org/10.1016/s0363-5023(97)80110-4
13. BIYANI, A., SIMISON, A. J., & KLENERMAN, L. (1995). Fractures of the distal radius and ulna. Journal of Hand Surgery, 20(3), 357-364. https://doi.org/10.1016/s0266-7681(05)80094-4
14. STOFFELEN, D., DE SMET, L., & BROOS, P. (1998). The importance of the distal Radioulnar joint in distal radial fractures. Journal of Hand Surgery, 23(4), 507-511. https://doi.org/10.1016/s0266-7681(98)80134-4
15. Zenke Y, Sakai A, Oshige T. Clinical results of distal radius fractures with ulnar styloid fractures. J Orthop Sci. 2009;14(6):798–803.
16. Kim, J. K., Koh, Y., & Do, N. (2010). Should an ulnar styloid fracture be fixed following volar plate fixation of a distal radial fracture? The Journal of Bone and Joint Surgery-American Volume, 92(1), 1-6. https://doi.org/10.2106/jbjs.h.01738
17. Souer JS, Ring D. Mismatch between radiographic and clinical outcomes following distal radius fractures. J Hand Surg Am. 2008;33(7):1111–1116.
18. Hauck, R. M., Skahen, J., & Palmer, A. K. (1996). Classification and treatment of ulnar styloid nonunion. The Journal of Hand Surgery, 21(3), 418-422. https://doi.org/10.1016/s0363-5023(96)80355-8
19. NAKAMURA, T., YABE, Y., & HORIUCHI, Y. (1996). Functional anatomy of the triangular fibrocartilage complex. Journal of Hand Surgery, 21(5), 581-586. https://doi.org/10.1016/s0266-7681(96)80135-5
20. Adams, B. D. (1998). Distal radioulnar joint instability. Instructional course lectures, 47, 209-213. https://doi.org/10.1016/b978-0-323-39253-2.50105-1
21. Anderson ML, Larson AN, Moran SL. Clinical comparison of distal radius fractures with and without ulnar styloid fractures. J Hand Surg Am. 2008;33(6):888–894.
22. Mulders MA, Walenkamp MM, van Dieren S. Functional outcomes of distal radius fractures with and without ulnar styloid fractures. Injury. 2013;44(12):1938–1942.
23. Belloti JC, Moraes VY, Albers MB. Does ulnar styloid fracture affect the outcome of distal radius fractures? Clin Orthop Relat Res. 2010;468(12):3263–3269.
24. Kazemian GH, Taghizadeh S, Fattahi AS. Functional outcome of distal radius fractures with associated ulnar styloid fracture. Arch Bone Jt Surg. 2014;2(3):168–172.
25. Sammer DM, Rizzo M. Ulnar styloid fractures: anatomy, biomechanics, and clinical implications. Hand Clin. 2010;26(4):503–512.
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