Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture
Sualp Turan1, Deniz Çankaya1, Serdar Yılmaz1, Dilek Karakuş2, Abdurrahim Dündar1, Güzelali Özdemir1
1Department of Orthopedics and Traumatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
2Department of Physical Therapy and Rehabilitation, Ankara Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey
Keywords: Cast; closed reduction; distal radius fracture; isokinetic evaluation; ulnar styloid.
Objectives: 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).
Patients and methods: 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.
Results: 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.
Conclusion: 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.