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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Ulnar Styloid Process Frx


- Anatomy:
     - Tunnel V:
          - overlies distal ends of radioulnar articulation on dorsum of wrist, contains EDM;
    - Tunnel VI:
          - in groove between the apex of ulnar styloid process & ulnar head, contains ECU tendon which is palpable from where it passes over ulnar styloid process to its insertion into the side of 5th metacarpal base;


- Exam:
    - ulnar styloid process: on the distal tip of the ulnar styloid process, you should feel small, shallow dorsal groove running longitundinally;
    - ECU tendon runs thru this groove;
    - it is most easily palpated when hand is radiallly deviated & tendon is contracted;
    - ECU is more palpable when wrist is extended & ulnarly deviated;
    - tenderness in area of ulnar styloid process may be due to either pathology w/ in process itself or to a colles frx w/ assoc frx of the distal end of ulnar styloid process;


- Management of Frx:
    - frxs of ulnar styloid process are assoc w/ frxs of distal radius and TFCC tears;
    - avulsion frx:
          - frxs involving lesser portions of ulnar styloid do not seen to be associated w/ significant instability of distal radioulnar joint;
          - w/ minimally displaced frx involves ulnar styloid, place upper extremity in long arm posterior splint in mid supination for 3-4 weeks;
          - supination is the normal anatomic position of the forearm and reduces subluxation of the ulnar head;
    - base frx:
          - ulnar styloid fractures at its base disrupt the major stabilizing ligaments of the distal ulna and TFCC and may lead to instability of the distal RU joint;
          - see RU joint instability;
          - closed reduction and pinning: fixation is achieved with 0.035 inch K wire or with use of a cannulated screw;
          - open reduction:
                 - a displaced ulnar styloid frx which occurs along w/ a unstable distal radius frx, should be considered for ORIF;
                 - surgical approach: incision is made between the ECU and the FCU;
                 - consider intra-osseous wiring or a tension band construct



Triangular Fibrocartilage Complex Tears Associated With Symptomatic Ulnar Styloid Nonunions 

Repair of the triangular ligament in Colles' fracture. No effect in a prospective randomized study.

Effect of an Unrepaired Fracture of the Ulnar Styloid Base on Outcome After Plate-and-Screw Fixation of a Distal Radial Fracture

Comparison of united and nonunited fractures of the ulnar styloid following volar-plate fixation of distal radius fractures.




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, December 21, 2012 11:43 am