[Surgical treatment of the ulnar styloid process using an angle-stable hook plate in fractures and symptomatic
Gero Knapp1, Florian Möller2, Christian Heiß2
1Klinik und Poliklinik für Unfall‑, Hand- und Wiederherstellungschirurgie - Operative Notaufnahme, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen, Rudolf-Buchheim-Str. 7, 35392, Gießen, Deutschland. gero.knapp@chiru.med.uni-giessen.de.
Objective:
Anatomical reduction of dislocated fractures using an angle-stable hook plate. Surgical revision of symptomatic nonunions with the aim of bone regeneration.
Indications:
Dislocated fractures of the ulnar styloid process with involvement of the ulnar fovea. Combined fractures with instability of the distal radioulnar joint and symptomatic nonunions.
Contraindications:
Undisplaced fractures of the ulnar styloid process and asymptomatic nonunions.
Surgical Technique:
Dorsoradial access to the distal ulna between the 6th extensor tendon compartment and the tendon of the flexor carpi ulnaris muscle. Exposition of the fracture/nonunion. In case of nonunions, excision and freshening of the fracture ends. Reduction is carried out using the hooks of the plate, if necessary additional attachment of autologous cancellous bone in case of nonunions. Fixation of the plate over the gliding hole and subsequent filling of the angular stable screw holes.
Postoperative Management:
Depending on the accompanying injury, immobilization in a forearm plaster splint for 1-2 weeks. Active movement exercises of the fingers from postoperative day 1, if necessary lymph drainage. After bone development, load build-up under ergotherapy guidance.
Results:
Bony healing was achieved in 100% of our cases. The surgical treatment of symptomatic nonunions as well as dislocated fractures of the ulnar styloid process using an angle-stable hook plate has proven to be successful.
More Related Videos
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:15Bones of the Upper Limb: Ulna