Clementsen Ståle Ørstavik, Jakobsen Rune Bruhn, Hammer Ola-Lars, Randsborg Per-Henrik
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway.
JB JS Open Access. 2022 Sep 22;7(3). doi: 10.2106/JBJS.OA.22.00021. eCollection 2022 Jul-Sep.
Ulnar styloid fractures (USFs) are often associated with distal radial fractures (DRFs). When unstable DRFs are treated surgically, any associated USF is most commonly left untreated. The purpose of this study was to evaluate the effect of a concomitant USF on outcome after surgical stabilization of a DRF.
Data from 2 randomized controlled trials on the treatment of unstable DRFs were pooled. The effect of a USF on the QuickDASH, EQ-5D, pain, and range of motion at 2 years was evaluated.
Two hundred and eighty-one patients were included; 177 (63%) had an associated, untreated USF. An unadjusted analysis demonstrated no significant difference in functional or patient-reported outcome measures (PROMs) at 2 years between patients with or without a concomitant USF. When controlling for confounding factors, the presence of a USF did not predict change in any of the PROMs from baseline to 2 years. A concomitant USF also did not predict change in grip strength or range of motion, except for a small effect on extension (-4.1°; 95% confidence interval, -7.5° to -0.8°; p = 0.02), which probably does not have clinical relevance.
A USF in combination with a DRF does not affect PROMs, range of motion, or grip strength. We recommend that concomitant USFs be left untreated when treating a DRF with surgical fixation.
Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.
尺骨茎突骨折（USF）常与桡骨远端骨折（DRF）相关。当不稳定的DRF进行手术治疗时，任何相关的USF最常见的是不予治疗。本研究的目的是评估合并USF对DRF手术稳定术后结果的影响。
汇总两项关于不稳定DRF治疗的随机对照试验的数据。评估USF对2年时的QuickDASH、EQ-5D、疼痛和活动范围的影响。
纳入281例患者；177例（63%）合并有未治疗的USF。未经调整的分析显示，合并或未合并USF的患者在2年时的功能或患者报告结局指标（PROMs）无显著差异。在控制混杂因素后，USF的存在并不能预测从基线到2年任何PROMs的变化。合并USF也不能预测握力或活动范围的变化，除了对伸展有小的影响（-4.1°；95%置信区间，-7.5°至-0.8°；p = 0.02），这可能没有临床相关性。
USF合并DRF不影响PROMs、活动范围或握力。我们建议在手术固定治疗DRF时，合并的USF不予治疗。
预后I级。有关证据水平的完整描述，请参阅作者指南。
