A Comparison of Outcomes after K-Wire Fixation of Distal Radius Fractures with and without Associated Ulnar Styloid Fracture

Abstract

Purpose:

A prospective study was carried out to compare outcomes after K-wire fixation of distal radius fractures without and with associated ulnar styloid fracture, but without fixation of the styloid fracture.

Patients and Methods:

70 patients, 60 women (86%) and 10 men (14%) with a mean age of 63 years were enrolled. 35 patients had an isolated fracture of the distal radius and 35 had an associated fracture of the ulnar styloid. All patients underwent percutaneous, “augmented” K-wire fixation of the distal radius fracture; the ulnar styloid fracture was left untreated. The patients were followed-up at 3 and 6 months. The stability of the distal radioulnar joint and the DASH scores were considered to be primary outcome measures.

Results:

Instability of the distal radioulnar joint was diagnosed in 2 patients with ulnar styloid fracture. No significant and clinically meaningful differences were found between the groups in clinical (pain, wrist mobility, grip strength, DASH score) and radiological outcomes. The rate of non-union of the ulnar styloid was 77% at final assessment.

Conclusion:

An unrepaired ulnar styloid fracture does not affect the outcome of a distal radius fracture which is fixed by the “augmented” K-wire method.

Zusammenfassung

Ziel:

Vergleich der klinischen und radiologischen Ergebnisse nach K-Drahtfixation distaler Speichenbrüche ohne und mit gleichzeitiger Fraktur des Ellengriffels, wobei dieser jedoch nicht befestigt wurde.

Patienten und Methode:

In die prospektive Studie wurden 70 Patienten (60 Frauen=86% und 10 Männer=14%) mit einem Durchschnittsalter von 63 Jahren eingeschlossen. 35 Patienten hatten eine isolierte Fraktur des distalen Radius, 35 gleichzeitig eine Ellengriffelfraktur. Der distale Radius wurde bei allen Patienten mittels einer „augmentierten“ K-Drahtspickung stabilisiert, während die Fraktur des Ellengriffels unversorgt blieb. Die Patienten wurden nach 3 und 6 Monaten nachuntersucht. Primäre Beurteilungskriterien waren dabei die Stabilität des distalen Radioulnargelenkes und der DASH-Score.

Ergebnisse:

Eine Instabilität des distalen Radioulnargelenkes fand sich bei 2 Patienten mit zusätzlicher Fraktur des Ellengriffels. Weder für die klinischen (Schmerz, Handgelenksbeweglichkeit, Kraft, DASH-Score) noch für die radiologischen Ergebnisse fand sich ein signifikanter Unterschied zwischen den beiden Gruppen.

Schlussfolgerung:

Unversorgte Frakturen des Ellengriffels beeinflussen nicht das Ergebnis mittels „augmentierter“ K-Drahtspickung stabilisierter distaler Radiusfrakturen.

Key words

distal radius fracture - ulnar styloid fracture - distal radioulnar joint ­instability

Schlüsselwörter

distale Radiusfraktur - Ellengriffelfraktur - Instabilität des distalen Radioulnargelenkes

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