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Fixation versus Conservative Treatment of Basal Fractures of the Ulnar Styloid after Volar Plate Fixation of Distal Radius Fractures without DRUJ Instability
Ahmed Afifi, MD, Orthopedic Department, Cairo University, Cairo, Egypt

Background
Distal radius fractures are usually associated with ulnar styloid fractures which may affect functional outcome. Fixation of ulnar styloid fractures has been debated for a long time. The aim of this study was to compare the results of fixation and conservative management of ulnar styloid basal fractures after volar plating of distal radius fractures in absence of DRUJ instability.
Patients and Methods
This prospective randomized controlled trial was conducted at a single center between 2015 and 2019. The study included 70 patients with basal ulnar styloid fractures associated with distal radius fractures without DRUJ instability. Patients were randomized into 2 equal groups; the fixation group and the conservative treatment group. Patients were assessed for pain by Visual Analogue Scale (VAS) and grip strength compared to the sound side. Functional evaluation was performed by using the Modified Mayo Wrist Score (MMWS) the Quick-DASH (Disabilities of the Arm, Shoulder, and Hand) questionnaire.
Results
The differences in outcomes in both groups were statistically insignificant. In the fixation group, the mean follow-up period was 24.2 ± 5.3 months. The mean final visual analogue scale (VAS) for pain was 0.9 ± 1, the mean grip strength was 88.3 % ± 9.2 of the sound side, the mean modified Mayo wrist score (MMWS) was 86.6 ± 5.6, and the mean quick DASH score was 5.7 ± 2.6. In the conservative treatment group, the mean follow-up period was 24.1 ± 5.6. The mean final visual analogue scale (VAS) for pain was 1.1 ± 0.9, the mean grip strength was 86.6 % ± 7.9 of the sound side, the mean modified Mayo wrist score (MMWS) was 86.4 ± 5.7, and the mean quick DASH score was 6.1 ± 2.5.
Conclusion
Fixation of basal ulnar styloid fractures after volar plate fixation of distal radius fractures didn't yield superior outcomes compared to conservative treatment in absence of DRUJ instability.


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