[Does fracture of the ulnar styloid accompanying fracture of the distal radius influence final outcome of the treatment? A review]

Abstract

Fractures of the ulnar styloid commonly accompany fractures of the distal radius, but their effect on the final outcome and need of separate treatment are not precisely determined. The objective of this review was to present the issue based on current literature. To date, results of both experimental and clinical studies show potentially negative effect of ulnar styloid fracture due to possible avulsion of the attachment of triangular fibro-cartilage complex and instability of the distal radio-ulnar joint. These injuries are more common when the base of the ulnar styloid is broken and considerably displaced, as well as at comminuted fracture of the distal radius. However, results of clinical studies show optimal treatment of the distal radius fracture to be essential for final anatomical and functional outcome, while ulnar styloid fracture or union are of lesser importance. Minor and slightly displaced ulnar styloid injuries do not require separate treatment at distal radius fractures. There are not definitive recommendations for major and much dislocated fractures, involving ulnar head and resulting in distal radio-ulnar joint instability. However, excellent results after stable fixation of the distal radius fractures with locking palmar plates suggest this management optimal, regardless the severity of distal ulna damage.