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Masters Thesis | Orthopaedic Surgery | India | Volume 12 Issue 1, January 2023 | Rating: 5.3 / 10
Can an Ulnar Styloid Fracture Affect the Range of Motion of Wrist Joint when Associated with Extra Articular Distal Radius Fracture Undergo Non-Surgical Treatment?
Habby T Jacob
Abstract: Introduction: The most frequent fracture we encounter in daily practice is distal radius fracture. It has impact on people of all ages, from teenagers to the elderly. Different forms of treatment have developed, from conservative ones using casting to surgical ones including percutaneous pinning, external fixation, and internal fixation. Numerous studies conducted up to this point have demonstrated various treatment methods, all provide outstanding functional outcomes. But there is a paucity of studies which address the associated ulnar styloid fractures and its association to the functional outcomes of the wrist joint. In this study we are studying the Range of movement of wrist joint when an ulnar styloid fracture is associated with distal radius fractures that undergo a non-surgical modality of treatment. Objectives: Our objective is to determine the functional outcome of wrist joint by assessing the range of movements of wrist joint in extra articular distal end of radius fracture with and without an associated ulnar styloid fracture. Methodology: A total of 60 patients coming to our hospital OPD /Casualty with extra articular distal radius fracture were followed in the 1.5 years study period. In our study, patients received non-operative care, as closed reduction and below the elbow casting. Each patient was analyzed for six months, during which time each patient received three functional evaluations on range-of-motion. Assessments were performed in first month (1ST assessment), third months (2ND assessment), and sixth (3RD assessment) months respectively after the injury. Statistical Analysis was done using SPSS23. Results on continuous measurements are presented on mean ? SD and result on categorical measurements is presented in numbers (%). Significance is assessed at 5% level. Normality of numerical data was checked. The significance of distal radius fracture with and without ulnar styloid fracture was expressed in mean ? SD statistical significance is assessed using repeated measured anova test and t test. Results: The mean age was 54.3 ? 15.1years with 38 females and 22 males. In our study, out of 60 participants all the subjects received non-surgical treatment (100%). P value of distal end of radius fracture associated with ulnar styloid fracture for of ulnar deviation (0.003), supination (0.004) and pronation (0.004) were statistically significant. p value for radial deviation (0.1) palmar flexion (0.1) and dorsi flexion (0.9) pain (0.1) were >0.05 and they are found to be statistically not significant. Conclusion: When ulnar styloid fracture was associated with distal radius fracture, there was significant statistical difference in terms of ulnar deviation, supination and pronation. There was no significant difference in radial deviation, dorsiflexion or palmar flexion if the distal radius fracture is associated with ulnar styloid fracture or not. This study can be however useful in determining if to fix the ulnar styloidfractures when associated with extra articular distal radius fractures.
Keywords: Distal radius fracture, Ulnar styloid fracture, wrist functional outcome, triangular fibro cartilage complex, Range of motion wrist.
Edition: Volume 12 Issue 1, January 2023
Pages: 1199 - 1203