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Unbehandelter Abriss des Processus styloideus ulnae

Kein schlechteres Behandlungsergebnis bei distaler Radiusfraktur

Unrepaired fracture of the styloid process of the ulna

Not a bad treatment result at distal radius fracture

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Zusammenfassung

Hintergrund

Kriterien zur Indikation und Art der Versorgung einer distalen Radiusfraktur sind etabliert. Über die Notwendigkeit einer operativen Versorgung der häufigen Begleitfraktur des Processus styloideus ulnae herrscht jedoch noch Uneinigkeit. Gegenstand der vorliegenden Studie war die Frage der Behandlungsbedürftigkeit dieser Verletzung.

Methoden

Mindestens ein Jahr postoperativ wurden 238 von 480 Patienten mit operativ versorgter distaler Radiusfraktur nachuntersucht. Eine Versorgung des Ulnastyloids fand in diesem Zeitraum nicht statt. Die Patienten wurden in 3 Gruppen unterteilt: ohne Ulnastyloidfraktur, mit Spitzen- und mit Basisabriss. Die funktionellen und radiologischen Ergebnisse wurden gemessen. Durch eine multivariate Analyse (MANOVA) wurde ermittelt, ob ein basisnaher oder peripherer Styloidabriss das radiologische oder funktionelle Ergebnis beeinflusst.

Ergebnisse

Weder das Vorhandensein noch die Lokalisation eines Abrisses des Processus styloideus ulnae hatten einen signifikanten Einfluss auf die funktionellen und radiologischen Ergebnisse (pfunktionell=0,849, pradiologisch=0,330, pScores=0,426, MANOVA).

Schlussfolgerung

Bei anatomischer Reposition und adäquater Refixation der distalen Radiusfraktur erscheint eine operative Versorgung von Spitzenabrissen als auch basisnaher Frakturen des Processus styloideus ulnae nicht notwendig.

Abstract

Background

There are well-defined criteria for the treatment of distal radius fractures but the impact of an unrepaired fracture of the styloid process of the ulnar on recovery after operative treatment is uncertain. This study evaluated radiological and functional results after different operative treatment procedures of distal radius fractures in patients with an untreated fracture of the styloid process of the ulna and those without such a fracture.

Methods

Out of 480 patients with operatively treated distal radius fractures 238 were examined at least 1 year after injury. The fracture of the styloid process of the ulna was not repaired. Three groups (patients without a fracture of the styloid process of the ulna, patients with a tip fracture and those with a basal fracture) were evaluated by multivariate analysis (MANOVA) in order to detect influences of the fracture of the styloid process of the ulna on the radiological and functional results.

Results

Neither the existence nor the location of the fracture of the styloid process of the ulna had a significant effect on the radiological and functional results (pfunction=0,849, pradiology=0,330, pscores=0,426, MANOVA).

Conclusions

The repair of a fracture of the styloid process of the ulna is not necessary if reduction and fixation of the distal radius fracture is anatomical and stable.

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Authors and Affiliations

  1. Klinik für Unfallchirurgie, Universitätsklinikum der Otto-von-Guericke-Universität, Leipziger Str. 44, 39120, Magdeburg, Deutschland

    M. Reichl, S. Piatek & S. Winckler

  2. Institut für Biometrie und Medizinische Informatik, Otto-von-Guericke-Universität, Magdeburg, Deutschland

    D. Adolf

  3. Abteilung Unfallchirurgie/Orthopädie, Klinikum Südstadt, Rostock, Deutschland

    T. Westphal

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  1. M. Reichl
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  2. S. Piatek
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  4. S. Winckler
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  5. T. Westphal
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Correspondence to M. Reichl.

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Reichl, M., Piatek, S., Adolf, D. et al. Unbehandelter Abriss des Processus styloideus ulnae. Unfallchirurg 114, 1099–1104 (2011). https://doi.org/10.1007/s00113-010-1859-8

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