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...
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Format: | Article |
Language: | English |
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BMC
2020-07-01
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Series: | Journal of Orthopaedic Surgery and Research |
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Online Access: | http://link.springer.com/article/10.1186/s13018-020-01795-3 |
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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 |
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