Untreated ulnar styloid fractures do not compromise wrist function in patients with distal radius fractures: A...

Ulnar styloid fractures (USF) often occur in conjunction with distal radius fractures (DRF). This study aims to compare wrist prognosis between DRF patients with untreated USF and those with isolated DRF, and to assess the impact of different USF fracture types.

A systematic search was conducted in databases such as PubMed, Embase, and the Cochrane Library, up to January 17, 2026. Randomized controlled trials (RCTs) and cohort studies comparing the wrist joint prognosis of patients with DRF combined with USF and those with isolated DRF were included. The primary outcome measure was the patient-reported wrist joint function score, and the secondary outcome measures were grip strength and wrist joint range of motion (ROM).

11 studies involving 1383 patients were included. In the short-term (≤6 months) follow-up, the wrist function score of patients with DRF combined with USF was statistically inferior to that of patients with DRF alone (SMD = 0.20, 95% CI: 0.05-0.34, P = 0.01), but the effect size was small and the clinical significance was limited. In the medium- to long-term (≥6 months) follow-up, there was no significant statistical difference in wrist function scores between the two groups (SMD = 0.11, 95% CI: -0.02-0.24, P = 0.11). Further analysis indicated that there was no significant statistical difference in prognosis between patients with base fractures and those with tip fractures at 3 and 12 months postoperatively. Additionally, there was no significant statistical difference in grip strength and wrist joint range of motion (including flexion, extension, pronation, supination, ulnar deviation, and radial deviation) between the two groups after surgery.

Untreated USF do not compromise wrist function in patients with DRF, regardless of the USF fracture type. Based on the existing evidence, non-intervention for USF in clinical practice may not lead to poor prognosis.

CRD420261286648.