Abstract
Soft tissue lesions around the distal ulna as well as fractures of the styloid process are common in association with dorsally displaced distal radius fractures. A majority of the ligamentous injuries appear to affect the triangular fibrocartilage complex (TFCC) in varying degrees. Dorsal fracture displacement more than 34° from anatomic position has been found impossible with intact TFCC attachment. The injury may cause ulno-carpal or distal radio-ulnar joint (DRUJ) instability. In low-demand patients, this however appears well tolerated. Early repair in the acute stage is recommended with severe instability, particularly in high-demand patients. Concomitant fractures of the ulnar styloid process have not, in adults, been found to affect outcome, and early repair is not recommended if sufficient wrist stability can be achieved by treatment of the radius fracture.
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References
Adolfsson L, Jörgsholm P. Arthroscopically-assisted reduction of intra-articular fractures of the distal radius. J Hand Surg Br. 1998;23:391–5.
Frykman G. Fracture of the distal radius including sequelae-shoulder hand finger syndrome, disturbance in the distal radio-ulnar joint and impairment of nerve function. A clinical and experimental study. Acta Orthop Scand. 1967;Suppl 108:3.
Geissler WB, Freeland AE, Savoie FH, et al. Intra-articular soft-tissue lesions associated with an intra-articular fracture of the distal end of the radius. J Bone Joint Surg Am. 1996;78:357–65.
Haugstvedt JR, Husby T. Results of repair of peripheral tears in the triangular fibrocartilage complex using an arthroscopic suture technique. Scand J Plast Reconstr Surg Hand Surg. 1999;33:439–47.
Krämer S, Meyer H, O’Laughlin PF, Vaske B, Krettek C, Gaulke R. The incidence of ulnocarpal complaints after a distal radial fracture in relation to the fracture of the ulnar styloid. J Hand Surg Eur Vol. 2013;38:710–7.
Lindau T, Arner M, Hagberg L. Intraarticular lesions in distal fractures of the radius in young adults. A descriptive arthroscopic study in 50 patients. J Hand Surg Br. 1997;22:638–43.
Moritomo H. Advantages of open repair of foveal tear of the triangular fibrocartilage complex via a palmar surgical approach. Tech Hand Up Extrem Surg. 2009;13:176–81.
Mrkonjic A, Geijer M, Lindau T, Tägil M. The natural course of traumatic triangular fibrocartilage complex tears in distal radial fractures: a 13–15 year follow-up of arthroscopically diagnosed but untreated injuries. J Hand Surg Am. 2012;37:1555–60.
O’Neill TW, Cooper C, Finn JD, Lunt M, Purdie D, Reid DM, Rowe R, Woolf AD, Wallace WA. UK Colles’ Fracture Study Group. Incidence of distal forearm fracture in British men and women. Osteoporos Int. 2001;12:555–8.
Reichl M, Piatek S, Adolf D, Winckler S, Westphal T. Unrepaired fracture of the styloid process of the ulna: not a bad treatment result at distal radius fracture. Unfallchirurg. 2011;114:1099–104.
Richards RS, Bennett JD, Roth JH, Milne Jr K. Arthroscopic diagnosis of intra-articular soft tissue injuries associated with distal radial fractures. J Hand Surg Am. 1997;22:772–6.
Sammer DM, Shah HM, Shauver MJ, Chung KC. The effect of ulnar styloid fractures on patient-rated outcomes after volar locking plating of distal radius fractures. J Hand Surg Am. 2009;34:1595–602.
Sasao S, Beppu M, Kihara H, Hirata K, Takagi M. An anatomical study of the ligaments of the ulnar compartment of the wrist. Hand Surg. 2003;8:219–26.
Scheer JH, Adolfsson LE. Pathomechanisms of ulnar ligament lesions of the wrist in a cadaveric distal radius fracture model. Acta Orthop. 2011;82:360–4.
Scheer JH, Adolfsson LE. Patterns of triangular fibrocartilage complex (TFCC) injury associated with severely dorsally displaced extra-articular distal radius fractures. Injury. 2012;43:926–32.
Souer JS, Ring D, Matschke S, Audige L, Marent-Huber M, Jupiter JB. AOCID Prospective ORIF Distal radius Study Group. Effect of an unrepaired fracture of the ulnar styloid base on outcome after plate-and-screw fixation of a distal radial fracture. J Bone Joint Surg Am. 2009;91:830–8.
Zenke Y, Sakai A, Oshige T, Moritani S, Nakamura T. Treatment with or without internal fixation for ulnar styloid base fractures accompanied by distal radius fracture fixed with volar locking plate. Hand Surg. 2012;17:181–90.
Zoetch S, Kraus T, Weinberg AM, Heidari N, Lindtner RA, Singer G. Fracture of the ulnar styloid process negatively influences the outcome of paediatric fractures of the distal radius. Acta Orthop Belg. 2013;79:48–53.
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Adolfsson, L., Scheer, J. (2014). Acute Injuries Around the Distal Ulna. In: Hove, L., Lindau, T., Hølmer, P. (eds) Distal Radius Fractures. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54604-4_28
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DOI: https://doi.org/10.1007/978-3-642-54604-4_28
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