A comparative study on surgical management of distal end radius fracture with ulnar styloid fracture with and without ulnar styloid fixation

Year : 2019 | Volume : 7 | Issue : 1 Page : 14-17

T Koner Rao¹, M Nagendra Babu², R Karthik Reddy³, V Krishna Kumar⁴

¹Associate Professor,²Professor & HOD,³,⁴Post graduate students, Department of Orthopedics, Pratima Institute of Medical Sciences, Karimnagar, Telangana, India.

Address for correspondence: Dr T Koner Rao, Associate Professor, Department of Orthopedics, Pratima Institute of Medical Sciences, Karimnagar, Telangana, India.

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Abstract

Introduction: Fractures of the distal radius are the most common fractures of the upper extremity and account for 17% of all fractures treated in the emergency room. Initially thought to be simple fractures , they are now recognized as complex injuries with a high percentage of long term complications.

Aims and Objectives: To Observe the results and assess the Functional outcome of the management of Distal End Radius Fractures by plating, with and without ulnar styloid fixation with Tension Band Wiring (TBW) and to know the complications associated.

Materials and Methods :This is a prospective study from January 2015 to December 2017. Out of 40 patients of this study, radius was fixed by volar plating in all patients,where as ulnar styloid - fixed by TBW in 20pts and in remaining left without fixation at Department of orthopedics, Pratima Institute of Medical Sciences, Karimnagar. All patients were selected among admissions, operated and results were assessed clinically and radiographically. Clinical evaluation was done using modified Demerit score system of Gartland and Werely. Perioperative complications recorded. Mean followup period was 6months.

Results:: We had 10(50%) in ulnar styloid fixation and 9(45%) in ulnar styloid non fixation cases rated as excellent, as they had no deformity of the wrist and there was no pain. None of the patient had poor modified Demerit score system of Gartland and Werely. Complications like irritation of EPL due to K- wire(25%), loosening of K-wire(5%), stiffness (5%) seen in patients with ulnar styloid fixation. Ulnar sided wrist pain is seen in 20% of cases without ulnarstyloid fixation. Conclusion:In fixation group of ulnar styloid , excellent to good results were seen in 90% of patients, In non fixation of ulnar styloid group , excellent to good results were seen in 80% of patients suggesting that stabilizing the distal radius fracture fragments with volar plate and screws ,is only required method [in both groups] to maintain the anatomical reduction which is crucial in maintaining stability of DRUJ, till union and to prevent collapse of the fracture fragments.

Keywords:Distal radius fracture, Ulnar styloid fixation, TBW- tension band wiring, Volar plating