Wong K C, Wu Mwf, Zai Qjj, Wong M K, Howe T S, Koh Sbj, Soeharno H
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
Department of Urology, Gleneagles Hospital, Singapore.
Malays Orthop J. 2023 Mar;17(1):142-148. doi: 10.5704/MOJ.2303.017.
Current literature reports varied significance of ulnar styloid fractures (USF) associated with distal radius fractures. Our study assesses the role of ulnar styloid fractures and fragment size in surgically managed distal radius fractures.
We reviewed patients who underwent surgical fixation of distal radius fractures between January 2004 to June 2006. Patients were divided into those with (Group 1) and without (Group 0) USFs. Post-operative radiographic parameters, clinical outcomes and overall wrist function were analysed. Outcomes included ulnar-sided wrist pain, extensor carpi ulnaris (ECU) tendinitis, triangular fibrocartilage complex (TFCC) grind test, distal radioulnar joint (DRUJ) instability and pain. Overall wrist function was assessed with range of motion and Disabilities of the Arm, Shoulder and Hand (DASH) score.
Our study cohort included 31 males and 23 females, and 38.9% of these patients had concomitant USFs. There was no difference in terms of demographic data and fracture configuration between groups. Radiographic parameters were similar, except for palmar tilt, which was significantly higher in Group 1 (4.6º vs 9.4º, p=0.047). At 24 months, there were no differences in clinical outcomes and overall wrist function. A sub-group analysis showed that mean USF fragment size was larger in patients with a positive TFCC grind test (3.9mm vs 7.3mm, p=0.033).
The presence of USFs in surgically managed distal radius fractures does not compromise clinical and functional outcome. Similarly, the size of USFs does not impact clinical and functional outcome but is associated with the presence of a positive TFCC grind test.
当前文献报道了与桡骨远端骨折相关的尺骨茎突骨折（USF）的不同意义。我们的研究评估了尺骨茎突骨折及其碎片大小在手术治疗桡骨远端骨折中的作用。
我们回顾了2004年1月至2006年6月期间接受桡骨远端骨折手术固定的患者。患者被分为有尺骨茎突骨折组（第1组）和无尺骨茎突骨折组（第0组）。分析术后影像学参数、临床结果和整体腕关节功能。结果包括尺侧腕部疼痛、尺侧腕伸肌（ECU）肌腱炎、三角纤维软骨复合体（TFCC）研磨试验、桡尺远侧关节（DRUJ）不稳定和疼痛。通过活动范围和上肢、肩部和手部功能障碍（DASH）评分评估整体腕关节功能。
我们的研究队列包括31名男性和23名女性，其中38.9%的患者伴有尺骨茎突骨折。两组之间的人口统计学数据和骨折形态无差异。影像学参数相似，但掌倾角除外，第1组的掌倾角显著更高（4.6°对9.4°，p = 0.047）。在24个月时，临床结果和整体腕关节功能无差异。亚组分析显示，TFCC研磨试验阳性的患者尺骨茎突骨折碎片平均尺寸更大（3.9mm对7.3mm，p = 0.033）。
手术治疗的桡骨远端骨折中存在尺骨茎突骨折不会影响临床和功能结果。同样，尺骨茎突骨折的大小不影响临床和功能结果，但与TFCC研磨试验阳性有关。
