Yıl: 2016 Cilt: 27 Sayı: 2 Sayfa Aralığı: 87 - 93 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture

Öz:
Amaç: Bu çalışmada ayrılmış radius distal uç kırığı (RDUK) sonrası konservatif tedavi edilen aktif hastalarda eşlik eden ulnar stiloid kırığının (USF) klinik sonuçlar ve el-bilek kas gücü üzerindeki etkisi araştırıldı.Hastalar ve yöntemler: Ekim 2012 - Eylül 2014 tarihleri arasında yapılan bu retrospektif çalışmaya kapalı redüksiyon ve alçı ile tedavi edilen ayrılmış RDUK'li 56 hasta (34 erkek, 22 kadın; ort. yaş 28.8 yıl; dağılım 20-40 yıl) dahil edildi. Hastalar ulnar stiloidin durumuna göre; grup A (sağlam ulnar stiloid), grup B (kaynamayan USF) ve grup C (iyileşmiş USF) olmak üzere üç gruba ayrıldı. Kavrama gücü, hızlı-kol, omuz ve el için engellilik (DASH) skoru ve eklem hareket açıklıkları değerlendirildi; sonuçlar el-bilek bölgesi izokinetik kas kuvvetlerinin ölçümleriyle birleştirildi. Distal radyoulnar eklem yaralanmasının ve triangular fibrokıkırdak kompleks (TFCC) lezyonunun eşlik edip etmediğini değerlendirmek amacıyla RDUK'ye manyetik rezonans görüntüleme uygulandı.Bulgular: Gruplar arasında eklem hareket açıklığı, kavrama gücü ve hızlı-DASH skorları yönünden anlamlı bir farklılık yoktu. Ancak, supinasyonun pik tork ve toplam iş değerleri grup A'da grup B'ye kıyasla daha iyiydi (sırasıyla, p=0.008 ve p=0.006). Manyetik rezonans görüntüleme bulgularına göre, TFCC lezyonu tespit edilen on hastanın dördü grup C'de, beşi grup B'de ve biri grup A'da idi.Sonuç: Bu çalışmanın bulguları RDUK'nin ilk tedavisinde USF'ye odaklanılmaması gerektiğini ve eşlik eden TFCC lezyonu olması halinde cerrahi girişimin düşünülebileceğini önermektedir.
Anahtar Kelime:

Konular: Ortopedi

Radius distal uç kırığının konservatif tedavisi sonrasında ulnar stiloid kırığının sonuçlar üzerine etkisi

Öz:
Objectives: This study aims to investigate the effect of accompanying ulnar styloid fracture (USF) on clinical outcomes and hand-wrist muscle strength in conservatively treated active patients after displaced distal radius fracture (DRF).Patients and methods: The retrospective study, which was conducted November 2012 and September 2016, included 56 patients (34 males, 22 females; mean age 28.8 years; range 20 to 40 years) with displaced DRF treated with closed reduction and casting. Patients were divided into three groups according to ulnar styloid status as group A (intact ulnar styloid), group B (USF non-union), and group C (healed USF). Grip strength, quick-disabilities of the arm, shoulder and hand (DASH) score, and joint range of motions were evaluated; the results were combined with measurements of isokinetic muscle strengths of hand-wrist region. Magnetic resonance imaging was performed to evaluate the accompaniment of distal radioulnar joint injury and triangular fibrocartilage complex (TFCC) lesion.Results: There were no significant differences between the groups regarding joint range of motion, grip strength, and quick-DASH scores. However, the peak torque and total work of supination was better in group A compared to group B (p=0.008 and p=0.006, respectively). According to the magnetic resonance imaging findings, of the 10 patients with detected TFCC lesion, four were in group C, five in group B, and one was in group A.Conclusion: Results of this study suggest that USF should not be the focus of attention during initial treatment of DRF and surgical intervention might be considered in case of an accompanying TFCC lesion.
Anahtar Kelime:

Konular: Ortopedi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Nakamura T, Iwamoto T, Matsumura N, Sato K, Toyama Y. Radiographic and Arthroscopic Assessment of DRUJ Instability Due to Foveal Avulsion of the Radioulnar Ligament in Distal Radius Fractures. J Wrist Surg 2014;3:12-7.
  • 2. Wijffels MM, Keizer J, Buijze GA, Zenke Y, Krijnen P, Schep NW, et al. Ulnar styloid process nonunion and outcome in patients with a distal radius fracture: a meta-analysis of comparative clinical trials. Injury 2014;45:1889-95.
  • 3. Kim JK, Yun YH, Kim DJ, Yun GU. Comparison of united and nonunited fractures of the ulnar styloid following volar-plate fixation of distal radius fractures. Injury 2011;42:371-5.
  • 4. Gogna P, Selhi HS, Mohindra M, Singla R, Thora A, Yamin M. Ulnar styloid fracture in distal radius fractures managed with volar locking plates: to fix or not? J Hand Microsurg 2014;6:53-8.
  • 5. Atik OŞ. Do not treat the radiograph, treat the patient! Eklem Hastalik Cerrahisi 2015;26:125.
  • 6. Belloti JC, Moraes VY, Albers MB, Faloppa F, Dos Santos JB. Does an ulnar styloid fracture interfere with the results of a distal radius fracture? J Orthop Sci 2010;15:216-22.
  • 7. Sammer DM, Chung KC. Management of the distal radioulnar joint and ulnar styloid fracture. Hand Clin 2012;28:199-206.
  • 8. Ozasa Y, Iba K, Oki G, Sonoda T, Yamashita T, Wada T. Nonunion of the ulnar styloid associated with distal radius malunion. J Hand Surg Am 2013;38:526-31.
  • 9. 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;35:223-7.
  • 10. Scheer JH, Adolfsson LE. Radioulnar laxity and clinical outcome do not correlate after a distal radius fracture. J Hand Surg Eur 2011;36:503-8.
  • 11. Fotiadou A, Patel A, Morgan T, Karantanas AH. Wrist injuries in young adults: the diagnostic impact of CT and MRI. Eur J Radiol 2011;77:235-9.
  • 12. Yilmaz S, Cankaya D, Karakus D. Ulnar styloid fracture has no impact on the outcome but decreases supination strength after conservative treatment of distal radial fracture. J Hand Surg Eur Vol 2015;40:872-3.
  • 13. Ploegmakers JJ, The B, Brutty M, Ackland TR, Wang AW. The effect of a Galeazzi fracture on the strength of pronation and supination two years after surgical treatment. Bone Joint J 2013;95:1508-13.
  • 14. Meyer H, Krämer S, O'Loughlin PF, Vaske B, Krettek C, Gaulke R. Union of the ulnar styloid fracture as a function of fracture morphology on conventional radiographs. Skeletal Radiol 2013;42:1135-41.
  • 15. Scheer JH, Adolfsson LE. Radioulnar laxity and clinical outcome do not correlate after a distal radius fracture. J Hand Surg Eur Vol 2011;36:503-8.
  • 16. Lindau T, Hagberg L, Adlercreutz C, Jonsson K, Aspenberg P. Distal radioulnar instability is an independent worsening factor in distal radial fractures. Clin Orthop Relat Res 2000;376:229-35.
  • 17. Protopsaltis TS, Ruch DS. Triangular fibrocartilage complex tears associated with symptomatic ulnar styloid nonunions. J Hand Surg Am 2010;35:1251-5.
  • 18. Argintar E, Mantovani G, Pavan A. TFCC reattachment after traumatic DRUJ instability: a simple alternative to arthroscopic management. Tech Hand Up Extrem Surg 2010;14:226-9.
APA TURAN S, ÇANKAYA D, YILMAZ S, KARAKUŞ D, DÜNDAR A, ÖZDEMİR G (2016). Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture. , 87 - 93.
Chicago TURAN SUALP,ÇANKAYA Deniz,YILMAZ Serdar,KARAKUŞ DİLEK,DÜNDAR Abdurrahim,ÖZDEMİR Güzelali Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture. (2016): 87 - 93.
MLA TURAN SUALP,ÇANKAYA Deniz,YILMAZ Serdar,KARAKUŞ DİLEK,DÜNDAR Abdurrahim,ÖZDEMİR Güzelali Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture. , 2016, ss.87 - 93.
AMA TURAN S,ÇANKAYA D,YILMAZ S,KARAKUŞ D,DÜNDAR A,ÖZDEMİR G Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture. . 2016; 87 - 93.
Vancouver TURAN S,ÇANKAYA D,YILMAZ S,KARAKUŞ D,DÜNDAR A,ÖZDEMİR G Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture. . 2016; 87 - 93.
IEEE TURAN S,ÇANKAYA D,YILMAZ S,KARAKUŞ D,DÜNDAR A,ÖZDEMİR G "Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture." , ss.87 - 93, 2016.
ISNAD TURAN, SUALP vd. "Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture". (2016), 87-93.
APA TURAN S, ÇANKAYA D, YILMAZ S, KARAKUŞ D, DÜNDAR A, ÖZDEMİR G (2016). Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), 27(2), 87 - 93.
Chicago TURAN SUALP,ÇANKAYA Deniz,YILMAZ Serdar,KARAKUŞ DİLEK,DÜNDAR Abdurrahim,ÖZDEMİR Güzelali Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.) 27, no.2 (2016): 87 - 93.
MLA TURAN SUALP,ÇANKAYA Deniz,YILMAZ Serdar,KARAKUŞ DİLEK,DÜNDAR Abdurrahim,ÖZDEMİR Güzelali Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), vol.27, no.2, 2016, ss.87 - 93.
AMA TURAN S,ÇANKAYA D,YILMAZ S,KARAKUŞ D,DÜNDAR A,ÖZDEMİR G Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.). 2016; 27(2): 87 - 93.
Vancouver TURAN S,ÇANKAYA D,YILMAZ S,KARAKUŞ D,DÜNDAR A,ÖZDEMİR G Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.). 2016; 27(2): 87 - 93.
IEEE TURAN S,ÇANKAYA D,YILMAZ S,KARAKUŞ D,DÜNDAR A,ÖZDEMİR G "Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture." Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), 27, ss.87 - 93, 2016.
ISNAD TURAN, SUALP vd. "Effect of ulnar styloid fracture on outcomes after conservative treatment of distal radius fracture". Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.) 27/2 (2016), 87-93.