TITLE

Effect of an Unrepaired Fracture of the Ulnar Styloid Base on Outcome After Plate-and-Screw Fixation of a Distal Radial Fracture

AUTHOR(S)
Souer, J. Sebastiaan; Ring, David; Matschke, Stefan; Audige, Laurent; Marent-Huber, Marta; Jupiter, Jesse B.
PUB. DATE
April 2009
SOURCE
Journal of Bone & Joint Surgery, American Volume;Apr2009, Vol. 91-A Issue 4, p830
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: The impact of an unrepaired fracture of the ulnar styloid base on recovery after internal fixation of a fracture of the distal part of the radius is uncertain. We evaluated a series of patients with an internally fixed fracture of the distal part of the radius to test the hypothesis that there is no difference in wrist motion or function scores between those with an untreated fracture of the ulnar styloid base and those with no ulnar fracture. Methods: Two cohorts of seventy-six matched patients, one with a fracture of the ulnar styloid base and the other with no ulnar fracture, were retrospectively analyzed by examining data gathered in a prospective study of plate-and-screw fixation of distal radial fractures. Patients were matched forage, sex, AO fracture type, and injury mechanism. The two cohorts were analyzed for differences in motion, grip strength, pain, the Gartland and Werley score, the DASH (Disabilities of the Arm, Shoulder and Hand) score, and the SF-36 (Short Form-36) score at six, twelve, and twenty-four months postoperatively. In a second analysis, sixty-four patients with <2 mm of displacement of a fracture of the ulnar styloid base were compared with forty-nine patients with greater displacement. Differences between cohorts and within cohorts over time were determined with use of regression analysis and the likelihood ratio test. Results: No significant differences were found between patients with an unrepaired fracture of the ulnar styloid base and those with no ulnar fracture at any of the follow-up intervals. However, a trend was observed toward less grip strength at six months (71% [of that on the contralateral side] compared with 79%; mean difference, -8% [95% confidence interval = -15.3% to -0.6%]; p = 0.03) and less flexion (540 compared with 590; mean difference, -5° [95% confidence interval = - 11.7° to -0.8°]; p = 0.02) and ulnar deviation (32° compared with 36°; mean difference, -4° [95% confidence interval = -7° to -0.1°]; p = 0.05) at twenty-four months after surgery in patients with an untreated fracture of the ulnar styloid base. There were no significant differences with regard to any tested outcome measure between the patients with ≥2 mm of displacement of an unrepaired fracture of the ulnar styloid base and those with less displacement. Conclusions: An unrepaired fracture of the base of the ulnar styloid does not appear to influence function or outcome after treatment of a distal radial fracture with plate-and-screw fixation, even when the ulnar fracture was initially displaced ≥2 mm. Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
37614972

 

Related Articles

  • Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures. Hall, Jeremy A.; Beuerlein, Murray J.; McKee, Michael D. // Journal of Bone & Joint Surgery, American Volume;Mar2009 Supplement, Vol. 91-A, p74 

    BACKGROUND: Standard open reduction and internal fixation techniques have been successful in restoring osseous alignment for bicondylar tibial plateau fractures; however, surgical morbidity, especially soft-tissue infection and wound necrosis, has been reported frequently. For this reason,...

  • Fractures of the Capitellum and Trochlea. Guitton, Thierry G.; Doornberg, Job N.; Raaymakers, Ernst L. F. B.; Ring, David; Kloen, Peter // Journal of Bone & Joint Surgery, American Volume;Feb2009, Vol. 91-A Issue 2, p390 

    Background: Recent work has established that apparently isolated fractures of the capitellum are often more complex and involve the lateral epicondyle, trochlea, and posterior aspect of the distal part of the humerus. We assessed the experience with operative stabilization of fractures of the...

  • Thoracolumbar Burst Fractures Treated with Posterior Decompression and Pedicle Screw Instrumentation Supplemented with Balloon-Assisted Vertebroplasty and Calcium Phosphate Reconstruction. Marco, Rex A. W.; Kushwaha, Vivek P. // Journal of Bone & Joint Surgery, American Volume;Jan2009, Vol. 91-A Issue 1, p20 

    Background: The treatment of unstable thoracolumbar burst fractures with short-segment posterior spinal instrumentation without anterior column reconstruction is associated with a high rate of screw breakage and progressive loss of reduction. The purpose of the present study was to evaluate the...

  • Complication Rates Following Open Reduction and Internal Fixation of Ankle Fractures. SooHoo, Nelson F.; Krenek, Lucie; Eagan, Michael J.; Gurbani, Barkha; Ko, Clifford Y.; Zingmond, David S. // Journal of Bone & Joint Surgery, American Volume;May2009, Vol. 91-A Issue 5, p1042 

    Background: Ankle fractures are among the most common injuries treated by orthopaedic surgeons. The purpose of the present investigation was to examine the risks of complications after open reduction and internal fixation of ankle fractures in a large population-based study. Methods: With use of...

  • High-Tension Double-Row Footprint Repair Compared with Reduced-Tension Single-Row Repair for Massive Rotator Cuff Tears. Domb, Benjamin G.; Glousman, Ronald E.; Brooks, Adam; Hansen, Matthew; Lee, Thay Q.; Neal S. ElAttrache // Journal of Bone & Joint Surgery, American Volume;Nov2008 Supplement 4, Vol. 90-A, p35 

    The article reports on the results of research which was conducted in an effort to compare the biomechanical behavior of high tension double row repair compared with reduced tension single row repair in the treatment of massive rotator cuff tears. A discussion of the challenges that a massive...

  • Function Plateaus by One Year in Patients With Surgically Treated Displaced Midshaft Clavicle Fractures. Schemitsch, Laura; Schemitsch, Emil; Veillette, Christian; Zdero, Rad; McKee, Michael // Clinical Orthopaedics & Related Research;Dec2011, Vol. 469 Issue 12, p3351 

    Background: Based on short-term (1 year or less) followup, primary fixation of displaced midshaft clavicle fractures reportedly results in better function compared with that reported for nonoperative methods. Whether better function persists beyond 1 year is unclear. Questions/purposes: For...

  • Computer-Assisted Surgical Navigation Does Not Improve the Alignment and Orientation of the Components in Total Knee Arthroplasty. Young-Hoo Kim; Jun-Shik Kim; Yoowang Choi; Oh-Ryong Kwon // Journal of Bone & Joint Surgery, American Volume;Jan2009, Vol. 91-A Issue 1, p14 

    Background: Whether total knee arthroplasty with use of computer-assisted surgical navigation can improve the limb and component alignment is a matter of debate. We hypothesized that total knee arthroplasty with use of computer-assisted surgical navigation is superior to conventional total knee...

  • Imageless Navigation in Hip Resurfacing: Avoiding Component Malposition During the Surgeon Learning Curve. Romanowski, James R.; Swank, Michael L. // Journal of Bone & Joint Surgery, American Volume;Aug2008 Supplement 3, Vol. 90-A, p65 

    Background: Studies suggest that hip arthroplasty procedures performed in specialty hospitals or by physicians in practices with a high surgical volume are associated with a decreased rate of adverse outcomes related to component malpositioning. Little is known, however, about the influence of...

  • Does Computer-Assisted Surgery Improve Accuracy and Decrease the Learning Curve in Hip Resurfacing? A Radiographic Analysis. Seyler, Thorsten M.; Lai, Lawrence P.; Sprinkle, Denise I.; Ward, William G.; Jinnah, Riyaz H. // Journal of Bone & Joint Surgery, American Volume;Aug2008 Supplement 3, Vol. 90-A, p71 

    Background: Hip resurfacing is a technically demanding procedure in which accurate positioning of the femoral component is critical to the avoidance of early implant failures. The purpose of this study was to assess the accuracy of computer-assisted placement of the femoral component and to...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics