gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Outcome assessment of closed distal radius fracture and ulnar styloid fracture treatment with volar plate and screw fixation

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  • presenting/speaker Luís Mata Ribeiro - Hospital São José, Centro Hospitalar Lisboa Central, Lisbon, Portugal
  • Miguel Botton - Hospital CUF Descobertas, Lisbon, Portugal
  • Mota Da Costa - Hospital CUF Descobertas, Lisbon, Portugal

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1509

doi: 10.3205/19ifssh0529, urn:nbn:de:0183-19ifssh05297

Published: February 6, 2020

© 2020 Mata Ribeiro et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

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Objectives/Interrogation: Ulnar styloid fracture is very frequently associated with distal radius fractures. Nonetheless, its clinical impact and specially its treatment are still highly debatable. The main goal of this study is evaluating the clinical outcomes of patients submitted to volar plate fixation of the radius and screw fixation of the ulna styloid.

Methods: Retrospective study including all adult patient with closed distal radius fractures and ulnar styloid fractures operated in an orthopaedic department since June 2015 to June 2017 (2 years). Patients with concomitant hand fractures, with cognitive deficits or with a history of degenerative or traumatic wrist injuries were excluded from the study.

Variables studied included age, sex, associated injuries, dominant hand function, comorbidities as well as complications after surgery.

Preoperative radiographs were analysed and patients were operated by two senior surgeons using internal fixation with a volar locking plate for the radius and percutaneous/mini-open fixation with a screw for the ulna. In type B and C distal radius fractures (AO classification), arthroscopic assistance was used during the procedure.

To assess the clinical outcomes, DASH score, PRWE score and satisfaction and pain Visual Analog Scale (1-10) were completed 12 months after surgery. Radiographic assessment and range of motion measurement were also evaluated.

Results: A total of 26 patients were included in the study comprising 15 female and 11 male patients. Patients age varied from to 30 to 68 years old.

Average Total DASH score was 20,46 points and total PRWE score was 23,33 points. These values are in accordance with most data found in the literature. Average Paint at rest VAS score was quite low, 1,66 points. The average satisfaction VAS score was 8,88.

Radiographic control showed good bone consolidation in all patients. All patients, except one, recovered complete mobility of the wrist. The only exception was a patient with flexor tenosynovitis that needed plate removal 10 months post-op.

Conclusion: Ulnar styloid fixation produces good clinical results, allowing complete recovery of wrist mobility and significantly reducing pain complaints with very few complications. In cases of distal radius fractures and ulnar styloid fracture it seems that fixing both fractures gives better results.