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Ozben H, Uludag S, Ataker Y, Comert Ece S, Gudemez E. Distal radius fractures: What are the effects of ulnar styloid fracture and face-toface rehabilitation on the functional outcome? Acta Orthop Traumatol Turc 2023; 57:361-365. [PMID: 38454215 PMCID: PMC10837576 DOI: 10.5152/j.aott.2023.21245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 12/11/2023] [Indexed: 03/09/2024]
Abstract
OBJECTIVE This study aimed to investigate the effects of the accompanying ulnar styloid fracture and 2 different postoperative rehabilitation protocols on the final outcomes following surgical treatment of distal radius fractures. METHODS In this retrospective study, 47 patients (11 male, 35 female; mean age=52.6 years, age range=24-85) who underwent plate fixation for distal radius fractures were divided into 4 groups based on the presence of an ulnar styloid fracture and type of rehabilitation. To evaluate clinical outcomes, wrist range of motion (ROM), grip strength, lateral pinch strength, disabilities of the arm, shoulder, and hand (DASH) questionnaire scores and visual analog scale (VAS) scores were obtained at the final follow-up. The rehabilitation exercises of the patients in groups 1 and 2 were carried out in the physical therapy room by the hand therapist during the postoperative 2 months. Patients in groups 3 and 4 were supplied with videos of the exercises of each phase and instructed to carry out those exercises at home routinely. RESULTS Patients who received home rehabilitation programs demonstrated greater grip strength loss. Patients without accompanying ulnar styloid fractures had better DASH and VAS scores. Final wrist ROM and the duration for return to preinjury activity level did not differ among groups. CONCLUSION This study has suggested that accompanying ulnar styloid fractures may worsen the functional outcomes after plate fixation of distal radius fractures. Home-based programs may provide patients with adequate overall wrist function with certain drawbacks compared to rehabilitation under direct supervision.
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Affiliation(s)
- Hakan Ozben
- Department of Orthopaedics and Traumatology, Vehbi Koç Foundation, American Hospital, Istanbul, Turkey
| | - Serkan Uludag
- Department of Orthopaedics and Traumatology, Vehbi Koç Foundation, American Hospital, Istanbul, Turkey
| | - Yaprak Ataker
- Department of Physical Medicine and Rehabilitation, Vehbi Koç Foundation, American Hospital, Istanbul, Turkey
- Istanbul Esenyurt University, Faculty of Health Sciences, School of Physiotherapy, Istanbul, Turkey
| | - Sibel Comert Ece
- Department of Physical Medicine and Rehabilitation, Vehbi Koç Foundation, American Hospital, Istanbul, Turkey
| | - Eftal Gudemez
- Department of Orthopaedics and Traumatology, Vehbi Koç Foundation, American Hospital, Istanbul, Turkey
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Atiyya AN, Diab RA, Soliman RA. Styloid Ulna Window Approach for Repair of Avulsed Foveal Attachment of Triangular Fibrocartilage Complex. J Hand Surg Am 2022:S0363-5023(22)00611-6. [PMID: 36372596 DOI: 10.1016/j.jhsa.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/14/2022] [Accepted: 10/12/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE To describe a surgical approach for open repair of the triangular fibrocartilage complex foveal avulsion via ulnar styloid osteotomy, and to assess its clinical results. METHODS We reviewed 12 patients with distal radioulnar joint (DRUJ) instability due to isolated foveal avulsion of DRUJ ligaments. Wrist arthroscopy was conducted for all patients to exclude the presence of concomitant tear of the superficial part of the triangular fibrocartilage complex and to corroborate the diagnosis with a positive hook test. Through an ulnar approach between flexor and extensor carpi ulnaris, an ulnar styloid osteotomy was performed under image intensifier control just ulnar to the fovea of the head of the ulna. The avulsed foveal attachment was anchored through transosseous sutures passing from the fovea to the neck of the ulna. The ulnar styloid was fixed by means of screws or tension band wires. Outcome measures included clinical assessment of pain (visual analog scale), grip strength, DRUJ instability, range of motion of the wrist, and modified Mayo wrist score. Radiographic assessment was done to determine union of the ulnar styloid osteotomy, DRUJ subluxation, and any hardware-related problems. RESULTS Outcome measures were evaluated after a mean follow-up of 21 months. Healing of the osteotomy was obtained in all cases by 11 weeks. The DRUJ laxity, visual analog scale, and modified Mayo wrist score improved, while grip strength and range of motion remained unchanged. One patient had prominent hardware necessitating removal after union of the osteotomy. There were no reported cases of injury or neuropraxia of the dorsal cutaneous branch of the ulnar nerve. CONCLUSIONS Open repair of an avulsed foveal attachment of the triangular fibrocartilage complex using an ulnar styloid osteotomy is an alternative to either open or arthroscopic repair approaches. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic IV.
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Affiliation(s)
| | - Ramy Ahmed Diab
- Department of Orthopaedic Surgery, Ain Shams University, Cairo, Egypt.
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Kao HK, Wu YC, Lu CH, Hua Z, Chen MC, Tuan CC. Application of Simulated Arms with Real-Time Pressure Monitor in Casting and Splinting by Physiological Sensors. Sensors (Basel) 2021; 21:5681. [PMID: 34502572 DOI: 10.3390/s21175681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/03/2021] [Accepted: 08/15/2021] [Indexed: 11/17/2022]
Abstract
In the real condition, the small sensor found it difficult to detect the position of the pressure sore because of casting displacement clinically. The large sensor will detect the incorrect pressure value due to wrinkles without close to arm. Hence, we developed a simulated arm with physiological sensors combined with an APP and a cloud storage system to detect skin pressure in real time when applying a short arm cast or splint. The participants can apply a short arm cast or splint on the simulative arm and the pressure in the cast or splint could be immediately displaced on the mobile application. The difference of pressure values from six pressure detection points of the simulated arm between the intern and the attending physician with 20-year working experience were 22.8%, −7.3%, 25.0%, 8.6%, 38.2%, 49.6%, respectively. It showed that the difference of pressure values in two farthest points, such as radius stab and ulnar styloid, was maximal. The pressures on the skin surface of the short arm cast were within acceptable range. Doctors would obtain reliable reference data and instantly understand the tightness of the swathed cast which would enable them to adjust it at any time to avoid complications.
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Okoli M, Silverman M, Abboudi J, Jones C, Kirkpatrick W, Liss F, Takei TR, Wang M, Ilyas AM. Radiographic Healing and Functional Outcomes of Untreated Ulnar Styloid Fractures Following Volar Plate Fixation of Distal Radius Fractures: A Prospective Analysis. Hand (N Y) 2021; 16:332-337. [PMID: 31286791 PMCID: PMC8120582 DOI: 10.1177/1558944719855445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Ulnar styloid fractures (USFs) are common concomitant injuries associated with distal radius fractures (DRFs). Recent studies have found conflicting evidence on whether these fractures treated or untreated effect pain and functional outcomes. The purpose of this study was to prospectively evaluate pain and function outcomes of consecutively untreated USFs in surgically repaired DRFs. The study hypothesis was that there would be no difference in outcomes whether an USF is present or not, with all cases left untreated. Methods: A prospective study at a single institution of consecutive DRF treated surgically with volar locked plating was undertaken. No patients underwent fixation of an USF if present. There were no treated USF that were excluded. Patients with associated ulnar neck and shaft fractures were excluded. Functional outcome measures were analyzed using the Quick Disabilities of the Arm, Shoulder, and Hand score (QDASH) and the Patient-Rated Wrist Evaluation (PRWE) scores. Outcome measures were collected at 3 months and 1 year postoperatively. Results: There was an incidence of 52.2% (n = 70/134) USF associated with surgically treated DRF. By location, there were 52.9% (n = 37/70) ulnar styloid tip fractures and 46.1% (33/70) ulnar styloid base. There were 75.7% of USF (53/70) still not healed by 1-year follow-up. When comparing patients with a DRF without an USF versus DRF with an associated USF at 12 months, there was no statistical difference in the QDASH score (6.7 vs 8.4, P = .47) or the PRWE total score (4.8 vs 7.5, P = .24). Similarly, subgroup analysis showed no statistical difference in QDASH or PRWE scores at final follow-up in united USF versus nonunited USF subjects (QDASH 14.2 vs 6.8, P = .112; PRWE 14.8 vs 5.4, P = .185). Conclusions: USFs are a common concomitant injury occurring in nearly half of DRFs treated surgically. Our prospective cohort analysis showed that neither the presence, type, nor bony union status of a concomitant USF has any significant effect on patient outcomes or reoperations at 1-year postoperatively. Our study confirms our hypothesis that USF of the tip and base should be left untreated.
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Affiliation(s)
- Michael Okoli
- Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA
| | - Matthew Silverman
- Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA
| | - Jack Abboudi
- Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA
| | - Christopher Jones
- Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Frederic Liss
- Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA
| | - T. Robert Takei
- Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA
| | - Mark Wang
- Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA
| | - Asif M. Ilyas
- Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA,Asif M. Ilyas, Rothman Institute at Thomas Jefferson University, 925 Chestnut Street, Philadelphia, PA 19107, USA.
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Nakamura T, Moy OJ, Peimer CA. Relationship between Fracture of the Ulnar Styloid Process and DRUJ Instability: A Biomechanical Study. J Wrist Surg 2021; 10:111-115. [PMID: 33815945 PMCID: PMC8012095 DOI: 10.1055/s-0040-1719041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 08/28/2020] [Indexed: 10/23/2022]
Abstract
Background There has been clinical question in the treatment of ulnar styloid fracture with distal radius fracture, surgical fixation of the styloid fragment, or ignorance of the fragment. We examined relationship between size of the ulnar styloid fracture and distal radioulnar joint (DRUJ) stability biomechanically to answer the above clinical question. Methods Changes in the dorsopalmar stiffness of the DRUJ after experimentally simulating in four types of ulnar styloid fractures were examined in cadavers. After tip, middle, base-horizontal, and base-oblique type of styloid fractures were made sequentially, changes in dorsopalmar DRUJ stiffness were measured using the MTS machine in the intact wrist, for each fracture, at 60 degrees pronation, neutral, and 60 degrees supination, respectively. Additional cutting of the radioulnar ligament (RUL) at the fovea was also simulated with the base-horizontal fracture. Results The tip and middle type fractures did not demonstrate significant loss of stiffness compared with the intact. The base-horizontal fracture demonstrated only significant loss of stiffness in the dorsal direction (radius palmar; ulnar dorsal) with forearm in neutral rotation. The base-oblique fracture demonstrated significant loss of dorsopalmar stiffness of the DRUJ. Additional section of the RUL with the base-horizontal fracture induced significant loss of stiffness of the DRUJ compared with the intact. Conclusions Because the RUL originates from the fovea as well as from the base of the ulnar styloid, these results suggest that DRUJ instability closely correlates with how much of the bony fragment includes the originating portions of the RUL. The findings further suggest that larger base-oblique and base-horizontal fragments with resultant DRUJ instability must be reattached, but that even base-horizontal fragment as well as tip and middle ulnar styloid fragment can be ignored when there is no instability.
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Affiliation(s)
- Toshiyasu Nakamura
- Hand Center of Western New York, State University of New York at Buffalo, Buffalo, New York
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Owen J. Moy
- Hand Center of Western New York, State University of New York at Buffalo, Buffalo, New York
| | - Clayton A. Peimer
- Hand Center of Western New York, State University of New York at Buffalo, Buffalo, New York
- Department of Orthopaedic Surgery, Marquette General Hospital, Marquette, Michigan
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Scarano KA, Owusu-Sarpong S, Mulligan MT. Bilateral Ulnar Styloid Impaction Syndrome Treated with Ulnar Styloidectomy. J Wrist Surg 2019; 8:240-244. [PMID: 31192047 PMCID: PMC6546490 DOI: 10.1055/s-0038-1673408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 08/27/2018] [Indexed: 10/28/2022]
Abstract
Background Ulnar styloid impaction syndrome (USIS) is produced by the tip of an oversized ulnar styloid inappropriately contacting the triquetrum. This condition results in chondromalacia, synovitis, and ulnar-sided wrist pain. Case Description We report a rare case of bilateral USIS that presented with a prolonged course. The patient's symptoms resolved in both wrists following two separate ulnar styloidectomy procedures. Literature Review Our case differs from previous reports in that it involves a patient whose own history of USIS led to a timelier diagnosis of the same disease in the contralateral wrist. To the best of our knowledge, there are no prior reports of bilateral USIS. Clinical Relevance USIS remains an uncommon cause of ulnar-sided wrist pain and a particularly difficult diagnosis to confirm. Here, we illustrate that this syndrome can be confidently approached using a combination of careful attention to patient history, physical examination, and various imaging methods.
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Affiliation(s)
- Kyle A. Scarano
- Department of Biochemistry, Molecular and Cellular Biology, University of New Hampshire, Durham, New Hampshire
- Division of Orthopaedic Surgery, Albany Medical College, Albany, New York
| | - Stephane Owusu-Sarpong
- Division of Orthopaedic Surgery, Albany Medical College, Albany, New York
- Department of Biological Sciences, SUNY Albany, Albany, New York
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Abstract
BACKGROUND Fractures of the radial shaft with disruption of the distal radial ulnar joint (DRUJ) or Galeazzi fractures are treated with reduction of the radius followed by stability assessment of the DRUJ. In rare instances, the reduction of the DRUJ is blocked by interposed structures requiring open reduction of this joint. The purpose of this study is to review all cases of irreducible Galeazzi fracture-dislocations reported in the literature to offer guidelines in the diagnosis and management of this rare injury. METHODS A search of the MEDLINE database, OVID database, and PubMed database was employed using the terms "Galeazzi" and "fracture." Of the 124 articles the search produced, a total of 12 articles and 17 cases of irreducible Galeazzi fracture-dislocations were found. RESULTS The age range was 16 to 64 years (mean = 25 years). A high-energy mechanism of injury was the root cause in all cases. More than half of the irreducible DRUJ dislocations were not identified intraoperatively. In a dorsally dislocated DRUJ, a block to reduction in most cases (92.3%) was secondary to entrapment of one or more extensor tendons including the extensor carpi ulnaris, extensor digiti minimi, and extensor digitorum communis, with the remaining cases blocked by fracture fragments. Irreducible volar dislocations due to entrapment of the ulnar head occurred in 17.6% of cases with no tendon entrapment noted. CONCLUSIONS In the presence of a Galeazzi fracture, a reduced/stable DRUJ needs to be critically assessed as more than half of irreducible DRUJs in a Galeazzi fracture-dislocation were missed either pre- or intraoperatively.
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Affiliation(s)
- Nicholas J. Yohe
- Maimonides Medical Center, Brooklyn, NY, USA,Nicholas J. Yohe, Department of Orthopaedic Surgery, Maimonides Medical Center, 927 49th Street, Brooklyn, NY 11219, USA.
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Almedghio S, Arshad MS, Almari F, Chakrabarti I. Effects of Ulnar Styloid Fractures on Unstable Distal Radius Fracture Outcomes: A Systematic Review of Comparative Studies. J Wrist Surg 2018; 7:172-181. [PMID: 29576925 PMCID: PMC5864499 DOI: 10.1055/s-0037-1607214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022]
Abstract
Purpose In this literature review, functional outcomes such as Disability of Arm, Shoulder and Hand (DASH) score and the visual analog scale (VAS) of pain along with clinical outcomes such as range of movement and grip strength of treated distal radius fractures (DRF) accompanied with ulnar styloid fractures (USF) will be compared with those with isolated DRF. Materials and Methods We analyzed articles from MEDLINE, Embase, and CINAHL that met our predetermined inclusion and exclusion criteria as per the Preferred Reporting Items for Systematic Reviews and Meta-analysis statements. This resulted in the identification of 464 articles with 18 potentially eligible studies of which 6 were included at the full-text screening stage. The primary outcomes were wrist pain, range of motion, functional outcome and satisfaction, such as VAS, and the DASH questionnaire along with radiological assessment and incidence of complications. Results These studies involved 796 participants with DRF and 806 wrists with DRF; 444 (55%) of DRF had an associated USF. Three studies did not report any statistically significant difference in DASH scores between the DRF patients with or without USF. Two studies reported worse DASH scores in the group with associated USF. Wrist pain was reported to be statistically significantly worse in patients with associated USF in two studies. Grip strength did not exhibit a statistically significant difference in any groups in four studies. On assessing the range of motion of the wrist and forearm, only one study reported a statistically significant difference in flexion at 2 years follow-up, with less flexion in patients with USF. Conclusion This review suggests that there is no significant correlation between a USF and the functional and clinical outcomes of DRF treatment, albeit wrist pain and less flexion were reported in some studies to be associated with USF. There is a need for more robust evidence from large randomized controlled trials to specifically look at the effects of fixation versus nonfixation of USF on DRF, or large prospective cohort studies assessing DRF with and without USF, with a minimum of 12 months follow-up. Level of Evidence Level II-therapeutic.
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Affiliation(s)
- Sami Almedghio
- Department of Trauma and Orthopaedics, Dr Gray's Hospital, NHS Grampian, Elgin, United Kingdom
| | - Mohammed Shoaib Arshad
- Department of Trauma and Orthopaedics, Pennine Acute Hospitals NHS Trust, Royal Oldham Hospital, Oldham, United Kingdom
| | - Fayez Almari
- Department of Trauma and Orthopaedics, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Indranil Chakrabarti
- Department of Trauma and Orthopaedics, Rotherham NHS Foundation Trust, Rotherham, United Kingdom
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Abstract
BACKGROUND The deep portion of the distal radioulnar ligaments (DRUL) inserts on the ulnar fovea and is the most important stabilizer of the distal radioulnar joint (DRUJ). Ulnar styloid base fractures that include the ulnar fovea may cause DRUJ instability. METHODS DRUJ stability in pronosupination was evaluated in 12 fresh-frozen upper extremities (4 female) aged 52 to 68 years (mean: 58.8 years) using a custom fixture, which allowed free rotation of the radius around the fixed ulna. Optical motion capture was used to record rotation of the radius with respect to the ulna. Each specimen was subjected to 3 N m of torque in both supination and pronation under 4 conditions: intact, ulnar styloid osteotomy with disruption of the foveal insertion of the DRUL, ulnar styloid fixation, and DRUL transection. Group differences were compared using a 1-way repeated-measures analysis of variance and Tukey multiple comparison post hoc tests. RESULTS When compared with the intact condition, both ulnar styloid osteotomy and DRUL transection significantly increased mean pronation (by 9.40° and 15.21°, respectively) and supination (by 9.05° and 17.42°, respectively) of the forearm. Screw fixation only significantly reduced pronation compared with osteotomy (by 2.62°). Screw fixation did not significantly affect supination. CONCLUSIONS Ulnar styloid fractures that disrupt the fovea cause instability of the DRUJ in pronation and supination under 3 N m of torque in a cadaveric model. Screw fixation of ulnar styloid base fractures achieves anatomic reduction; however, it only partially returns rotational stability acutely to the DRUJ and only during pronation.
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Affiliation(s)
- Tyler S. Pidgeon
- The Warren Alpert Medical School of Brown University, Providence, RI, USA,Tyler S. Pidgeon, Department of Orthopaedics, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 2 Dudley Street, Suite 200, Providence, RI 02905, USA.
| | - Joseph J. Crisco
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Gregory R. Waryasz
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Douglas C. Moore
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Manuel F. DaSilva
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
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Sanmartín-Fernández M, Couceiro-Otero J, Costas-Alvarez M, Sotelo-Garcia A. Extensor carpi ulnaris tenosynovitis caused by the tip of an oversized ulnar styloid: a case report. J Wrist Surg 2015; 4:65-67. [PMID: 25709882 PMCID: PMC4327717 DOI: 10.1055/s-0034-1398473] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background Degenerative tendinopathy of the extensor carpi ulnaris (ECU) produced by the tip of an oversized ulnar styloid has not been formerly reported. Case Description We report an uncommon case of an injury to the ECU tendon that was related to a prominent oversized ulnar styloid. The patient's symptoms improved following resection of the styloid process. Literature Review Our case differs from previous reports in that it involves an uninjured oversized ulnar styloid that damaged the overlying ECU tendon with no apparent instability. Clinical Relevance Besides ulnar styloid impaction syndrome, the diagnosis of ECU tenosynovitis should also be considered in patients with ulnar-side pain and an oversized ulnar styloid.
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Affiliation(s)
| | - José Couceiro-Otero
- Hand Surgery Unit, Departament of Orthopedic Surgery and Traumatology, Povisa Hospital, Vigo, Spain
| | | | - Anahí Sotelo-Garcia
- Hand Surgery Unit, Departament of Orthopedic Surgery and Traumatology, Povisa Hospital, Vigo, Spain
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Abstract
Distal ulna fractures, especially styloid injuries, classically have not been repaired, and only recently have these injuries been considered important. Certain fracture patterns of the distal ulna contribute to distal radioulnar joint (DRUJ) incongruity and potential instability. Appropriate fixation of the distal ulna is frequently difficult for several reasons: (1) high incidence of osteoporois in the affected patient population, (2) proximity of the injury to articular surfaces, and (3) lack of a proper implant to treat these injuries. The 2.0-mm locking compression distal ulna plate (LC-DUP) is an anatomically contoured implant with a low profile and fixed angle that provides proper stability to treat injuries of the distal ulna. The plate was designed for the treatment of distal ulna fractures, but its success has led to an extension of its indications to be used in treating symptomatic basistyloid ulnar nonunions and in ulnar shortening osteotomy for ulnocarpal abutment syndrome. The authors' description of the techniques used for each indication as well as their perspectives in the treatment of distal ulna injuries are described in detail in this report.
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Affiliation(s)
- Fiesky A. Nunez
- Division of Surgical Sciences, Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Zhongyu Li
- Division of Surgical Sciences, Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Douglas Campbell
- Unit of Trauma and Orthopaedic Surgery, Leeds General Infirmary, Leeds, West Yorkshire, United Kingdom
| | - Fiesky A. Nunez
- Hand and Upper Extremity Service, Centro Medico Guerra Mendez, Valencia, Venezuela
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