The Effect Of The Treatment Of The Distal Radius Fracture With Or Without Ulnar Styloid Fixation

[Objective] To evaluate the short-term clinical effect of the treatment of the distal radius fracture with the ulnar styloid fracture.[Methods] From September2010to March2012, we choose80cases of patients with the distal radius fracture, which all of the fracture with the ulnar styloid fracture. Male,19cases, Female,61cases. There were62cases in our clinical following and Male,12cases, Female,50cases,the average age is48.3%(23age-72age). We performed open reduction and internal fixation (ORIF) on all of the patients with the volar locking or anatomical plate and screws. We used the8-Figure tension band (Ethicon thread) to fix the ulnar styloid fracture, and repair the peri-TFCC injury. There were32cases with the ulnar styloid fracture and obvious displacement, we performed ORIF on these patients. We evaluate the clinical effect with the standard AP and Lateral views to measure the ulnar tilt angle, volar tilt angle, the height of the radius and the variance of the ulnar. We use the Gartland-Werely score system to analyze and evaluate the results.[Result] The average period of hospitalization is9.4days, there were no skin complications, myocardial infarctions, cerebral infarctions, multiple organ failure, hemorrhagic shock, death or other serious complications. All of the62cases with distal radial fracture (DRF) were obtained bony union. For the patients with the ulnar styloid fracture, we grouped the patients as the operation group and conservative group, following9months after the operation, the height of the radius and the variance of the ulnar were all grouped by pathology classification and the result is insignificant in statistic. Comparatively, the X2tests (P<0.05) shows the wrist score are significant statistically after we analyze the data by Gartland-Werley system, and the rate of excellent in the operation group are obviously higher than the non-operation group.18cases got complications, included5cases in the operation group:2cases of wrist stiffness,2cases of tendon rupture,1case of arthralgia. On the other hand,13cases got complications in the non-operation group, included4cases of wrist stiffness,4cases of wrist pain,4cases of functional rotation limitation,1case of tendon rupture. There are no carpal tunnel syndrome or flexor tendinitis in both of the two groups, and both of them are significant statistically after the X2test (P<0.05).[Conclusion] According to our data,when we performed the open reduction and internal fixation (ORBF) on the distal radius fracture, we can get obviously positive effects and few complications in these patients who has the ulnar styloid fracture. With a short term following, for the patients with the ulnar styloid fracture, after analyze the lateral and AP view radiographs, we can see that both the operation group and non-operation group,9months after the operation, on the aspect of the height of the radius and the variance of the ulnar, the result is insignificant in statistics, on the aspect of the Gartland-Werley score system, the two groups has significant difference, on the aspect of complication rate, both of the two groups are significant statistically. The existence of the ulnar styloid fracture is the sign of TFCC injury. If the patients’ age is younger, for the reason of the high-energy injury mechanism, there is the tendency of the TFCC injury if there was ulnar styloid fracture. In the older patients, there is little difference in the DRF with or without ulnar styloid fracture, for the reason of the injury mechanism is lower-energy.