Radial styloidectomy: an anatomical study with special reference to radiocarpal intracapsular ligamentous morphology

This study determines the anatomical relationship of the radiocarpal ligaments to the radial styloid process, and the effect of three specific styloidectomies on the integrity of these ligaments. Thirty fresh cadaveric wrists were dissected. The origins, insertions, and dimensions of each ligament was determined. The thirty wrists were divided randomly into three equal groups and the ten wrists in each group had three types of styloidectomy: short oblique, vertical oblique, and horizontal. The styloid fragments and wrists were then reexamined to determine the integrity of the ligaments. All styloidectomies removed the radial collateral ligament origin. Vertical oblique styloidectomy removed additionally 92% of the radioscaphocapitate and 21% of the radiolunatotriquetral ligament. Horizontal styloidectomy removed 95% of the radioscaphocapitate, and 46% of the radiolunatotriquetral ligament. These findings indicate that the degree of radiocarpal ligament disruption that occurs after styloidectomy may be predicted accurately by correlating the amount of styloid removed, with the consistent ligamentous anatomy of this area.