Fixing ulnar Styloid Fracture with Stable Distal Radioulnar Joint: A Randomized Clinical Trial

The association between ulnar styloid fracture and distal radius fracture is common while the necessity of ulnar styloid fixation is still controversial. We have aimed to elucidate the effect of ulnar styloid fracture fixation on final outcome of distal radius fracture treatment.

In a two-arm randomized clinical trial, patients with Fernandez type I distal radius fracture associated with ulnar styloid fracture in the base were divided into two groups of fixed (group A) and unfixed (group B) ulnar styloid fracture. They were followed up for 12 months using pain visual analogue scale (VAS), quick form of the Disabilities of the Arm, Shoulder, and Hand (DASH) score questionnaire, and Mayo performance score as well as wrist range of motion and grip strength evaluation.

Quick DASH score was 35.4±14.0 in group A and 30.5±5.82 in group B (P=0.027) at 3-month follow-up and 29.8±18.2 in group A and 18.3±8.40 in group B At 6-month follow-up (P= 0.001). VAS score for pain was declined 4.46±2.17 and 3.64±0.96 after 6 months (P= 0.339) and 4.00±1.73 and 2.50±0.81 after 12 months (P= 0.352) in groups A and B, respectively. The mean Mayo wrist scores were measured as 59.3 and 57.8 in group A and B three months after the fracture, respectively (P= 0.504). We found no significant difference in the wrist range of motion and grip strength between two groups after three months (P>0.05).

According to our findings, ulnar styloid fixation using pin and wire have an adverse effect on distal radius fixation outcomes.