The authors address the significance of ulnar styloid fractures on the outcome of operatively treated distal radius fractures. There has been some debate as to the potential effect on range of motion, pain, stability, and arthritis with ulnar styloid fractures, and, data in the literature is limited. Previous authors have tried to associate characteristics including size and displacement of the ulnar styloid fragment with outcome.
This study retrospectively analyzed a previously compiled group of distal radius fractures treated with plate-and-screw fixation. They hypothesized that fixation of the ulnar styloid fragment would have no effect on outcomes for patients. Case controlled cohorts were developed comparing patients with untreated ulnar styloid fractures with patients without an ulnar fracture. There was no difference in the overall outcome (DASH and Gartland) between the two groups. Both continued to improve during the 6 month to one year interval. The ulnar styloid fracture group had diminished grip strength only at the six month follow-up. A separate cohort identified 132 patients with untreated ulnar styloid base fractures followed for at least 6 months to account for displacement. No difference in outcome was observed regardless of displacement.
The authors conclude that ulnar styloid fractures have no impact on the outcome of operatively treated radius injuries fractures. They do caution that their analysis did not include DRUJ instability. The authors suggest that patients with a distal radius and ulnar styloid fracture treated operatively with plate-and-screw fixation can reasonably expect equal functional outcome to those without ulnar styloid fracture.