Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire

Abstract Background Limited reference is available regarding surgical management in symptomatic ulnar styloid fractures with small bony avulsion. The study goal is to report the surgical outcomes using anchor suture fixation with comparison to traditional tension band wire fixation. Methods We retro...

Full description

Bibliographic Details
Main Authors: Alvin Chao-Yu Chen, Yi-Hsuan Lin, Chun-Jui Weng, Chun-Ying Cheng
Format: Article
Language:English
Published: BMC 2020-07-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13018-020-01795-3
_version_ 1817993696393560064
author Alvin Chao-Yu Chen
Yi-Hsuan Lin
Chun-Jui Weng
Chun-Ying Cheng
author_facet Alvin Chao-Yu Chen
Yi-Hsuan Lin
Chun-Jui Weng
Chun-Ying Cheng
author_sort Alvin Chao-Yu Chen
collection DOAJ
description Abstract Background Limited reference is available regarding surgical management in symptomatic ulnar styloid fractures with small bony avulsion. The study goal is to report the surgical outcomes using anchor suture fixation with comparison to traditional tension band wire fixation. Methods We retrospectively reviewed the medical records in patients who underwent surgical repair for unilateral ulnar styloid fractures with distal radioulnar instability between 2004 and 2017. A total of 31 patients were enrolled including two kinds of fixation methods. Anchor suture fixation plus distal radioulnar joint pinning was performed in ten patients with tiny avulsion bony fragments (group A); tension band wire fixation was performed in 21 patients with big styloid fracture fragments (group B). Patient characteristics and 2-year treatment outcomes were compared between two groups based on Mayo Modified Wrist Score (MMWS); Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH); visual analog scale (VAS), and surgical complication. Descriptive statistics were used for calculation of key variables; a p value of < 0.05 was considered statistically significant. Results Based on Gaulke classification, there were five subtypes in group A and three subtypes in group B. Incidence of concomitant distal radius fractures was significantly higher in group B; other patient characteristics including age, sex, injury side, and time to surgery showed no significant difference. Outcome assessment regarding MMWS, QuickDASH, and VAS was comparable between two groups. Bone-related complications including nonunion, DRUJ subluxation, and styloid resorption were analyzed; the difference was not significant. Incidence of implant-related complications including migration and secondary removal surgery was significantly higher in group B (p = 0.021). Conclusion Surgical fixation in symptomatic ulnar styloid fractures yields comparable treatment outcomes in both fracture patterns. Implant-related complication with secondary removal surgery is more common in tension band wire group. Anchor suture fixation is a feasible option for tiny styloid avulsion fragments with limited surgical complication.
first_indexed 2024-04-14T01:42:21Z
format Article
id doaj.art-77a34a615a5d44649eacdad1e798d9ab
institution Directory Open Access Journal
issn 1749-799X
language English
last_indexed 2024-04-14T01:42:21Z
publishDate 2020-07-01
publisher BMC
record_format Article
series Journal of Orthopaedic Surgery and Research
spelling doaj.art-77a34a615a5d44649eacdad1e798d9ab2022-12-22T02:19:40ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-07-011511710.1186/s13018-020-01795-3Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wireAlvin Chao-Yu Chen0Yi-Hsuan Lin1Chun-Jui Weng2Chun-Ying Cheng3Bone and Joint Research Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital–Linkou and Chang Gung University College of MedicineBone and Joint Research Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital–Linkou and Chang Gung University College of MedicineBone and Joint Research Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital–Linkou and Chang Gung University College of MedicineBone and Joint Research Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital–Linkou and Chang Gung University College of MedicineAbstract Background Limited reference is available regarding surgical management in symptomatic ulnar styloid fractures with small bony avulsion. The study goal is to report the surgical outcomes using anchor suture fixation with comparison to traditional tension band wire fixation. Methods We retrospectively reviewed the medical records in patients who underwent surgical repair for unilateral ulnar styloid fractures with distal radioulnar instability between 2004 and 2017. A total of 31 patients were enrolled including two kinds of fixation methods. Anchor suture fixation plus distal radioulnar joint pinning was performed in ten patients with tiny avulsion bony fragments (group A); tension band wire fixation was performed in 21 patients with big styloid fracture fragments (group B). Patient characteristics and 2-year treatment outcomes were compared between two groups based on Mayo Modified Wrist Score (MMWS); Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH); visual analog scale (VAS), and surgical complication. Descriptive statistics were used for calculation of key variables; a p value of < 0.05 was considered statistically significant. Results Based on Gaulke classification, there were five subtypes in group A and three subtypes in group B. Incidence of concomitant distal radius fractures was significantly higher in group B; other patient characteristics including age, sex, injury side, and time to surgery showed no significant difference. Outcome assessment regarding MMWS, QuickDASH, and VAS was comparable between two groups. Bone-related complications including nonunion, DRUJ subluxation, and styloid resorption were analyzed; the difference was not significant. Incidence of implant-related complications including migration and secondary removal surgery was significantly higher in group B (p = 0.021). Conclusion Surgical fixation in symptomatic ulnar styloid fractures yields comparable treatment outcomes in both fracture patterns. Implant-related complication with secondary removal surgery is more common in tension band wire group. Anchor suture fixation is a feasible option for tiny styloid avulsion fragments with limited surgical complication.http://link.springer.com/article/10.1186/s13018-020-01795-3Ulnar styloid; Distal radioulnar joint (DRUJ); Distal radius fracture (DRF)Suture anchorUltra-braid sutureTension band wire
spellingShingle Alvin Chao-Yu Chen
Yi-Hsuan Lin
Chun-Jui Weng
Chun-Ying Cheng
Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire
Journal of Orthopaedic Surgery and Research
Ulnar styloid; Distal radioulnar joint (DRUJ); Distal radius fracture (DRF)
Suture anchor
Ultra-braid suture
Tension band wire
title Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire
title_full Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire
title_fullStr Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire
title_full_unstemmed Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire
title_short Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire
title_sort surgical management of ulnar styloid fractures comparison of fixation with anchor suture and tension band wire
topic Ulnar styloid; Distal radioulnar joint (DRUJ); Distal radius fracture (DRF)
Suture anchor
Ultra-braid suture
Tension band wire
url http://link.springer.com/article/10.1186/s13018-020-01795-3
work_keys_str_mv AT alvinchaoyuchen surgicalmanagementofulnarstyloidfracturescomparisonoffixationwithanchorsutureandtensionbandwire
AT yihsuanlin surgicalmanagementofulnarstyloidfracturescomparisonoffixationwithanchorsutureandtensionbandwire
AT chunjuiweng surgicalmanagementofulnarstyloidfracturescomparisonoffixationwithanchorsutureandtensionbandwire
AT chunyingcheng surgicalmanagementofulnarstyloidfracturescomparisonoffixationwithanchorsutureandtensionbandwire