Influence of Associated Ulnar Styloid Fracture on Prognosis of Distal Radius Fracture_Chinese Journal of Evidence-Based Medicine

Authors：

 JINJia-cheng ¹ , ZHANGKun-peng ² ,  HUANGFu-guo ¹

1. Department of Orthopedics Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;
2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding?author：

HUANGFu-guo, Email: huang-f-g@163.com

Keywords：

Distal radius fracture; Ulnar styloid fracture; Prognosis; Systematic review; Meta-analysis; Cohort study

DOI：

10.7507/1672-2531.20140123

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Objective To systematically review the effects of associated ulnar styloid fracture on the prognosis of distal radius fracture. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 5 2013), CNKI, CBM and WanFang Data were searched up to May 2013 for collecting cohort studies about the effects of associated ulnar styloid fracture on the prognosis of distal radius fracture. According to the inclusion and exclusion criteria, related cohort studies were screened, data were extracted and cross-checked, and quality of included studies was independently evaluated by two reviewers. Meta-analysis was then conducted using RevMan 5.2 software. Results A total of 9 studies involving 1 020 patients were included. The results of meta-analysis showed that there was no significant difference in GartlandWerley score between patients with ulnar styloid fracture or not. Statistical significant difference was found in DASH score between the two groups (MD=2.71, 95% CI 0.26 to 5.16, P=0.03), which indicated that patients with ulnar styloid fracture got higher score in DASH score. Conclusion Current evidence shows that ulnar styloid fracture may affect the prognosis of patients with distal radius fracture. Due to the quality and quantity limitation of the included studies, the above conclusion needs to be further verified by more high quality studies in future.

Citation： JINJia-cheng, ZHANGKun-peng, HUANGFu-guo. Influence of Associated Ulnar Styloid Fracture on Prognosis of Distal Radius Fracture. Chinese Journal of Evidence-Based Medicine, 2014, 14(6): 729-733. doi: 10.7507/1672-2531.20140123 Copy

1.	?Wilcke MK, Hammerberg H, Adolphson PY. Epidemiology and changed surgical treatment methods for fractures of the distal radius. Acta Orthop, 2013, 84(3):292-296.
2.	May MM, Lawton JN, Blazar PE. Ulnar styloid fractures associated with distal radius fractures:incidence and implications for distal radioulnar joint instability. J Hand Surg Am, 2002, 27(6):965-971.
3.	Lindau T, Adlercreutz C, Aspenberg P, et al. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. J Hand Surg Am, 2000, 25(3):464-468.
4.	Amorosa LF, Vitale MA, Brown S, et al. A functional outcomes survey of elderly patients who sustained distal radius fractures. Hand, 2011, 6(3):260-267.
5.	Belloti JC, Moraes VY, Albers MB, et al. Does an ulnar styloid fracture interfere with the results of a distal radius fracture? J Orthop Scie, 2010, 15(2):216-222.
6.	Zenke Y, Sakai A, Oshige T, et al. Treatment with or without internal fixation for ulnar styloid base fractures accompanied by distal radius fractures fixed with volar locking plate. Hand Surg, 2012, 17(2):181-190.
7.	李書振, 陳躍平, 林宗漢, 等.尺骨莖突骨折對橈骨遠端骨折后腕關節功能的影響.中國修復重建外科雜志, 2012, 26(6):666-670.
8.	Kim JK, Koh YD, Do NH. Should an ulnar styloid fracture be fixed following volar plate fixation of a distal radial fracture?. J Bone Joint Surg Am, 2010, 92(1):1-6.
9.	Wells G, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in metaanalyses. Available at:http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm.
10.	張蓓, 王江, 葉建榮.腦鈉肽預測非心臟手術術后不良心血管事件發生的Meta分析.中國循證醫學雜志, 2012, 12(12):1463-1469.
11.	Jupiter JB, Fernandez DL, Toh CL, et al. Operative Treatment of Volar Intra-Articular Fractures of the Distal End of the Radius. J Bone Joint Surg, 1996, 78(12):1817-1828.
12.	Souer JS, Ring D, Matschke S, et al. Effect of an unrepaired fracture of the ulnar styloid base on outcome after plate-and-screw fixation of a distal radial fracture. J Bone Joint Surg, 2009, 91(4):830-838.
13.	Reichl M, Piatek S, Adolf D, et al. Unrepaired fracture of the styloid process of the ulna:not a bad treatment result at distal radius fracture. Unfallchirurg, 2011, 114(12):1099-1104.
14.	趙亮, 王寶軍, 李亞東, 等.尺骨莖突骨折及分型對橈骨遠端骨折術后臨床療效的隨訪研究.北京大學學報:醫學版, 2011, 43(5): 675-680.
15.	何家文, 禹寶慶, 黃建明, 等.尺骨莖突骨折對橈骨遠端骨折愈合及腕關節功能的影響.中國骨與關節外科, 2013, (5):430-433.
16.	Changulani M, Okonkwo U, Keswani T, et al. Outcome evaluation measures for wrist and hand:which one to choose?. Int Orthop, 2008, 32(1):1-6.
17.	Hudak P L, Amadio P C, Bombardier C. Development of an upper extremity outcome measure:the DASH (disabilities of the arm, shoulder and hand)[corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med, 1996, 29(6):602-608.
18.	Westphal T, Piatek S, Schubert S, et al. Reliability and validity of the upper limb DASH questionnaire in patients with distal radius fractures. Z Orthop Ihre Grenzgeb, 140(4):447-451.
19.	Gehrmann SV, Windolf J, Kaufmann RA. Distal radius fracture management in elderly patients:a literature review. J Hand Surg Am, 2008, 33(3):421-429.
20.	Sammer DM, Chung KC. Management of the distal radioulnar joint and ulnarstyloid fracture. Hand Clin, 2012, 28(2):199-206.
21.	Sammer DM, Shah HM, Shauver MJ, et al. The effect of ulnarstyloid fractures on patient-rated outcomes after volar locking plating of distal radius fractures. J Hand Surg Am, 2009, 34(9):1595-1602.
22.	Zyluk A, Mazur A, Puchalski P. A Comparison of Outcomes after K-Wire Fixation of Distal Radius Fractures with and without Associated Ulnar Styloid Fracture. Handchir Mikrochir Plast Chir, 2014, 46(1):7-11.
23.	Chen YX, Zheng X, Shi HF, et al. Will the untreated ulnar styloid fracture influence the outcome of unstable distal radial fracture treated with external fixation when the distal radioulnar joint is stable. BMC Musculoskelet Disord, 2013, 14:186.
24.	Buijze GA, Ring D. Clinical impact of United versus nonunited fractures of the proximal half of the ulnar styloid following volar plate fixation of the distal radius. J Hand Surg Am, 2010, 35(2):223-227.
25.	王丹, 翟俊霞, 牟振云, 等. Meta分析中的異質性及其處理方法.中國循證醫學雜志, 2009, 9(10):1115-1118.
26.	陳耀龍, 李幼平, 杜亮, 等.醫學研究中證據分級和推薦強度的演進.中國循證醫學雜志, 2008, 8(2):127-133.

1. ?Wilcke MK, Hammerberg H, Adolphson PY. Epidemiology and changed surgical treatment methods for fractures of the distal radius. Acta Orthop, 2013, 84(3):292-296.
2. May MM, Lawton JN, Blazar PE. Ulnar styloid fractures associated with distal radius fractures:incidence and implications for distal radioulnar joint instability. J Hand Surg Am, 2002, 27(6):965-971.
3. Lindau T, Adlercreutz C, Aspenberg P, et al. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. J Hand Surg Am, 2000, 25(3):464-468.
4. Amorosa LF, Vitale MA, Brown S, et al. A functional outcomes survey of elderly patients who sustained distal radius fractures. Hand, 2011, 6(3):260-267.
5. Belloti JC, Moraes VY, Albers MB, et al. Does an ulnar styloid fracture interfere with the results of a distal radius fracture? J Orthop Scie, 2010, 15(2):216-222.
6. Zenke Y, Sakai A, Oshige T, et al. Treatment with or without internal fixation for ulnar styloid base fractures accompanied by distal radius fractures fixed with volar locking plate. Hand Surg, 2012, 17(2):181-190.
7. 李書振, 陳躍平, 林宗漢, 等.尺骨莖突骨折對橈骨遠端骨折后腕關節功能的影響.中國修復重建外科雜志, 2012, 26(6):666-670.
8. Kim JK, Koh YD, Do NH. Should an ulnar styloid fracture be fixed following volar plate fixation of a distal radial fracture?. J Bone Joint Surg Am, 2010, 92(1):1-6.
9. Wells G, Shea B, O'Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in metaanalyses. Available at:http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm.
10. 張蓓, 王江, 葉建榮.腦鈉肽預測非心臟手術術后不良心血管事件發生的Meta分析.中國循證醫學雜志, 2012, 12(12):1463-1469.
11. Jupiter JB, Fernandez DL, Toh CL, et al. Operative Treatment of Volar Intra-Articular Fractures of the Distal End of the Radius. J Bone Joint Surg, 1996, 78(12):1817-1828.
12. Souer JS, Ring D, Matschke S, et al. Effect of an unrepaired fracture of the ulnar styloid base on outcome after plate-and-screw fixation of a distal radial fracture. J Bone Joint Surg, 2009, 91(4):830-838.
13. Reichl M, Piatek S, Adolf D, et al. Unrepaired fracture of the styloid process of the ulna:not a bad treatment result at distal radius fracture. Unfallchirurg, 2011, 114(12):1099-1104.
14. 趙亮, 王寶軍, 李亞東, 等.尺骨莖突骨折及分型對橈骨遠端骨折術后臨床療效的隨訪研究.北京大學學報:醫學版, 2011, 43(5): 675-680.
15. 何家文, 禹寶慶, 黃建明, 等.尺骨莖突骨折對橈骨遠端骨折愈合及腕關節功能的影響.中國骨與關節外科, 2013, (5):430-433.
16. Changulani M, Okonkwo U, Keswani T, et al. Outcome evaluation measures for wrist and hand:which one to choose?. Int Orthop, 2008, 32(1):1-6.
17. Hudak P L, Amadio P C, Bombardier C. Development of an upper extremity outcome measure:the DASH (disabilities of the arm, shoulder and hand)[corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med, 1996, 29(6):602-608.
18. Westphal T, Piatek S, Schubert S, et al. Reliability and validity of the upper limb DASH questionnaire in patients with distal radius fractures. Z Orthop Ihre Grenzgeb, 140(4):447-451.
19. Gehrmann SV, Windolf J, Kaufmann RA. Distal radius fracture management in elderly patients:a literature review. J Hand Surg Am, 2008, 33(3):421-429.
20. Sammer DM, Chung KC. Management of the distal radioulnar joint and ulnarstyloid fracture. Hand Clin, 2012, 28(2):199-206.
21. Sammer DM, Shah HM, Shauver MJ, et al. The effect of ulnarstyloid fractures on patient-rated outcomes after volar locking plating of distal radius fractures. J Hand Surg Am, 2009, 34(9):1595-1602.
22. Zyluk A, Mazur A, Puchalski P. A Comparison of Outcomes after K-Wire Fixation of Distal Radius Fractures with and without Associated Ulnar Styloid Fracture. Handchir Mikrochir Plast Chir, 2014, 46(1):7-11.
23. Chen YX, Zheng X, Shi HF, et al. Will the untreated ulnar styloid fracture influence the outcome of unstable distal radial fracture treated with external fixation when the distal radioulnar joint is stable. BMC Musculoskelet Disord, 2013, 14:186.
24. Buijze GA, Ring D. Clinical impact of United versus nonunited fractures of the proximal half of the ulnar styloid following volar plate fixation of the distal radius. J Hand Surg Am, 2010, 35(2):223-227.
25. 王丹, 翟俊霞, 牟振云, 等. Meta分析中的異質性及其處理方法.中國循證醫學雜志, 2009, 9(10):1115-1118.
26. 陳耀龍, 李幼平, 杜亮, 等.醫學研究中證據分級和推薦強度的演進.中國循證醫學雜志, 2008, 8(2):127-133.

Chinese Journal of Evidence-Based Medicine

Influence of Associated Ulnar Styloid Fracture on Prognosis of Distal Radius Fracture

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