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¿Es habitual fijar la fractura de estiloides cubital en fracturas de radiodistal? Unidad de Servicio de salud Red sur Occidente Kennedy 2018
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- reponame:Repositorio Institucional EdocUR; instname:Universidad del Rosario; MacIntyre NJ, Dewan N. Epidemiology of distal radius fractures and factors predicting risk and prognosis. J Hand Ther. 2016;29(2):136–45.; Rhee PC, Shin AY. Management of Complex Distal Radius Fractures : Review of Treatment Principles and Select Surgical Techniques. 2015;21(2):140–54.; Kim JK, Kim DJ, Yun Y. Natural history and factors associated with ulnar-sided wrist pain in distal radial fractures treated by plate fixation. J Hand Surg Eur Vol [Internet]. 2016;1–5. Available from:; Belloti JC, Moraes VY, Albers MB, Faloppa F, Gomes Dos Santos JB. Does an ulnar styloid fracture interfere with the results of a distal radius fracture? J Orthop Sci. 2010;15(2):216–22.; Gong HS, Cho HE, Kim J, Kim MB, Lee YH, Baek GH. Surgical treatment of acute distal radioulnar joint instability associated with distal radius fractures. J Hand Surg Eur Vol. 2015;40(8):783–9.; Lee DS, Weikert DR. Complications of Distal Radius Fixation. Orthop Clin North Am. 2016;47(2):415–24.; Zenke Y., Sakai A., Oshige T., Moritani S. NT. 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 Am [Internet]. 2009;91(4):830–8.; Kim JK, Koh Y, Do N, Surgery J. Should an Ulnar Styloid Fracture Be Fixed Following. J Bone Jt Surg [Internet]. 2011;92(1):1–6.; Ipaktchi K, Livermore M, Lyons C, Banegas R. Current concepts in the treatment of distal radial fractures. Orthopedics [Internet]. 2013;36(10):778–84.; Medoff RJ, Shin AY. Complex Distal Radius Fractures : An Anatomic Algorithm for Surgical. 2017;25(2):77–88.; Sammer DM, Shah HM, Shauver MJ, Chung KC. The Effect of Ulnar Styloid Fractures on Patient-Rated Outcomes After Volar Locking Plating of Distal Radius Fractures. J Hand Surg Am [Internet]. 2009;34(9):1595–602. Available from:; Plausinis D, Kwon YW, Zuckerman JD, Surgery J. Selected The American Academy of Orthopaedic Surgeons. 2010;884–94.; BROWNER. JUPITER. LEVINE. TRAFTON. Skeletal Trauma: Basic Science, Management, and Reconstruction. Elsevier. 3rd ed. Vol 1.; SCHATZKER, Joseph. TILE, Marvin. The Rationale of Operative Fracture Care. Springer. 3rd ed.; MUÑOZ, Jorge. Atlas de Mediciones Radiográfica en Ortopedia y Traumatología. McGraw-Hill Interamericana. 1st ed.; BERGER, Richard. WEISS, Arnorld. Hand Surgery. Lippincott Williams & Wilkins. 1st ed. 2004.; CHAPMAN, Michael. SZABO, Robert. Chapman’s Orthopaedic Surgery. Lippincott Williams & Wilkins. 3rd ed. 2001; CLANCEY, Gary. Percutaneous Kirschner-wire fixation of Colles fractures. A prospective study of thirty cases. En: The Journal of Bone and Joint Surgery. Needham. Vol 66. Issue 7. Págs 1008-1014. Año 1984.; BUIJZE, Geert. RING, David. Clinical Impact of United Versus Nonunited Fractures of the Proximal Half of The Ulnar Styloid Following Volar Plate Fixation of th Fistal Radius. En: The Journal of Hand Surgery. Vol 35A. Págs. 223 – 227. Año 2010.; NAKAMURA, Toshiyasu. MOY, Owen. Session 11: Forearm and Wirst 3. Relationship Betweewn the Ulnar Styloid Fracture and DRUJ Instability. En: The Journal of Hand Surgery. Vol 28B. Supplement 1. Pág 48.; MAY, Megan. LAWTON, Jeffrey. BLAZAR. Philip. Ulnar Styloid Fractures Associated With Distal Radius Fractures: Incidence and Implications for Distal Radioulnar Joint Instability. En; Journal of Hand Surgery. Vol 27A. Pásgs 965 – 971. Año 2002.; PROTOPSALTIS, Themistocles. RUSH, David. Triangular Fibrocartilage Complex Tears Associated With Symptomatic Ulnar Styloid Nonunios. En: The Journal of Hand Surgery. Vol 35A. Págs. 1251 – 1255. Año. 2010.; SAMMER, Douglas. SHAH, Hriday. The Effect of Ulnar Styloid Fractures on Patient-Rated Outcomes After Volar Locking Plating of Distal Radius Fracutres. En: The Journal of Hand Surgery. Vol. 34A. Págs. 1595 – 1602. Año. 2009.; ROYSAM, G. The Distal Radioulnar Joint in Colle´s Fractures. En: The Journal of Bone and Joint Surgery. Vol. 75B. Págs. 58-60. Año 1993.; Rikli DA, Regazzoni P. The double plating technique for distalradius fractures. J Bone Joint Surg-B 1996; 78B: 588-92.; Orbay J. Volar plate fixation of distal radius fractures. Hand Clin 2005;21(3): 347e54.; Lattmann T, Meier C, Dietrich M, Forberger J, Platz A. Results of volar locking plate osteosynthesis for distal radius fractures. J Trauma 2011 June;70(6): 1510e8.; Rozental TD, Blazar PE. Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius. J Hand Surg Am 2006 March;31(3):359e65.; Arora R, Lutz M, Hennerbichler A, Krappinger D, Espen D, Gabl M. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma 2007 May;21(5):316e22.; . Stoffelen D, De Smet L, Broos P. The importance of the distal radioulnar joint in distal radius fractures. J Hand Surg Br 1998 August;23(4):507e11.; Geissler WB, Fernandez DL, Lamey DM. Distal radioulnar joint injuries associated with fractures of the distal radius. Clin Orthop Relat Res 1996 June;327: 135e46.; Shaw JA, Bruno A, Paul EM. Ulnar styloid fixation in the treatment of posttraumatic instability of the radioulnar joint: a biomechanical study with clinical correlation. J Hand Surg Am 1990 September;15(5):712e20.; Zenke Y, Sakai A, Oshige T, Moritani S, Nakamura T. The effect of an associated ulnar styloid fracture on the outcome after fixation of a fracture of the distal radius. J Bone Jt Surg Br 2009 January;91(1):102e7.; Souer JS, Ring D, Matschke S, Audige L, Marent-Huber M, Jupiter JB, AOCID Prospective ORIF Distal Radius Study Group. Effect of an unrepaired fracture of the ulnar styloid base on outcome after plate-and-screw fixation of a distal radial fracture. J Bone Jt Surg Am 2009 April;91(4):830e8.; Kim JK, Koh YD, Do NH. Should an ulnar styloid fracture be fixed following volar plate fixation of a distal radius fracture? J Bone Jt Surg Am 2010 January;92(1):1e6.; Itadera E, Kunishi T, Kuniyoshi K. Wiring for ulnar styloid fractures associated with distal radius fractures. J Jpn Soc Surg Hand 2006;23(6):875e7 [in Japanese].; Buijze GA, Ring David. 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 February;35:223e7.; Sawada H, Shinohara T, Natsume T, Hirata H. Clinical effects of internal fixation for ulnar styloid fractures associated with distal radius fractures: A matched case-control study. J Orthop Sci. 2016 Nov;21(6):745-748.; Wijffels MM, Kaizer J, Buijze GA, Zenke Y. Ulnar styloid process nounion and outcome in patients with distal Radius fracture: a Meta- analysis comparativa clínica trials. Injury 2014.
- Publication Year :
- 2018
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Abstract
- Descripción de los hallazgos radiológicos en pacientes con fractura de radio distal tratados quirúrgicamente en la unidad de servicio de salud Red Sur Occidente Kennedy durante febrero a junio de 2018. La fractura de radio distal es una fractura común en el servicio de urgencias al que se enfrentan los ortopedistas en su ejercicio profesional, este tipo de fractura se asocia de forma frecuente a la fractura de estiloides cubital. Existe una verdadera controversia respecto a las indicaciones para la fijación de la estiloides cubital ya que no existe una clara correlación entre los efectos clínicos del manejo quirúrgico vs. conservador de la fractura de estiloides cubital. En el Servicio de Salud Red Sur Occidente Kennedy en un periodo de seis meses se recolectó una muestra de 40 pacientes con fractura de radio distal e indicación de manejo quirúrgico, con una edad media de 53 años (RIQ: 26-66 años). De estos pacientes el 72,5% presentó de forma asociada fractura de estiloides cubital, y solo el 27,6% requirió fijación de la misma y el 72, 4% recibió manejo conservador. La fractura de la base de la estiloides cubital, según la clasificación de Fernández tipo II corresponde a una factor de riesgo para inestabilidad radio-cubital distal, y tiene como resultados pobres consecuencias clínicas ya que esta sirve como lugar de inserción para el fibrocartílago triangular, por lo cual la evidencia soporta la fijación de la estiloides cubital en pacientes con fractura de la misma e inestabilidad radio-cubital distal asociada (Hideyoshi), sin embargo algunos estudios también indican que la no reparación de la fractura de estiloides cubital no afecta la función del puño cuando la fractura de radio distal es fijada mediante una placa de radio distal volar bloqueada (Zenke). En Colombia no existe un estudio comparativo de resultados clínicos entre la fijación y el manejo conservador de las fracturas de estiloides cubital, se desconoce la incidencia de este tipo de fractura, su trat<br />Description of the radiological findings in patients with distal radius fracture treated surgically in the South Western Kennedy Health Service during February to June 2018. The fracture of the distal radius is a common fracture in the emergency service faced by orthopedists in their professional practice, this type of fracture is frequently associated with ulnar styloid fracture. There is a real controversy regarding the indications for the fixation of the ulnar styloid since there is no clear correlation between the clinical effects of surgical management vs. conservative ulnar styloid fracture. At the South Western Kennedy Health Service, a sample of 40 patients with a distal radius fracture and indication of surgical management was collected over a period of six months, with a mean age of 53 years (RIQ: 26-66 years). Of these patients, 72.5% had associated ulnar styloid fractures, and only 27.6% required fixation of the same and 72.4% received conservative management. The fracture of the ulnar styloid base, according to the Fernández type II classification, corresponds to a risk factor for distal radio-ulnar instability, and results in poor clinical consequences since it serves as an insertion site for the triangular fibrocartilage, therefore, the evidence supports the fixation of the ulnar styloid in patients with fracture of the same and associated distal radio-ulnar instability (Hideyoshi), however some studies also indicate that the non-repair of the ulnar styloid fracture does not affect the function of the fist when the fracture of the distal radius is fixed by distal radius blocked plate. In Colombia there is no comparative study of clinical outcomes between fixation and conservative management of ulnar styloid fractures, the incidence of this type of fracture, its treatment and its association with distal radio-ulnar instability is not known, which is why we decided perform this study. These data of characterization of our population, the incidence of u
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- Journal :
- reponame:Repositorio Institucional EdocUR; instname:Universidad del Rosario; MacIntyre NJ, Dewan N. Epidemiology of distal radius fractures and factors predicting risk and prognosis. J Hand Ther. 2016;29(2):136–45.; Rhee PC, Shin AY. Management of Complex Distal Radius Fractures : Review of Treatment Principles and Select Surgical Techniques. 2015;21(2):140–54.; Kim JK, Kim DJ, Yun Y. Natural history and factors associated with ulnar-sided wrist pain in distal radial fractures treated by plate fixation. J Hand Surg Eur Vol [Internet]. 2016;1–5. Available from:; Belloti JC, Moraes VY, Albers MB, Faloppa F, Gomes Dos Santos JB. Does an ulnar styloid fracture interfere with the results of a distal radius fracture? J Orthop Sci. 2010;15(2):216–22.; Gong HS, Cho HE, Kim J, Kim MB, Lee YH, Baek GH. Surgical treatment of acute distal radioulnar joint instability associated with distal radius fractures. J Hand Surg Eur Vol. 2015;40(8):783–9.; Lee DS, Weikert DR. Complications of Distal Radius Fixation. Orthop Clin North Am. 2016;47(2):415–24.; Zenke Y., Sakai A., Oshige T., Moritani S. NT. 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 Am [Internet]. 2009;91(4):830–8.; Kim JK, Koh Y, Do N, Surgery J. Should an Ulnar Styloid Fracture Be Fixed Following. J Bone Jt Surg [Internet]. 2011;92(1):1–6.; Ipaktchi K, Livermore M, Lyons C, Banegas R. Current concepts in the treatment of distal radial fractures. Orthopedics [Internet]. 2013;36(10):778–84.; Medoff RJ, Shin AY. Complex Distal Radius Fractures : An Anatomic Algorithm for Surgical. 2017;25(2):77–88.; Sammer DM, Shah HM, Shauver MJ, Chung KC. The Effect of Ulnar Styloid Fractures on Patient-Rated Outcomes After Volar Locking Plating of Distal Radius Fractures. J Hand Surg Am [Internet]. 2009;34(9):1595–602. Available from:; Plausinis D, Kwon YW, Zuckerman JD, Surgery J. Selected The American Academy of Orthopaedic Surgeons. 2010;884–94.; BROWNER. JUPITER. LEVINE. TRAFTON. Skeletal Trauma: Basic Science, Management, and Reconstruction. Elsevier. 3rd ed. Vol 1.; SCHATZKER, Joseph. TILE, Marvin. The Rationale of Operative Fracture Care. Springer. 3rd ed.; MUÑOZ, Jorge. Atlas de Mediciones Radiográfica en Ortopedia y Traumatología. McGraw-Hill Interamericana. 1st ed.; BERGER, Richard. WEISS, Arnorld. Hand Surgery. Lippincott Williams & Wilkins. 1st ed. 2004.; CHAPMAN, Michael. SZABO, Robert. Chapman’s Orthopaedic Surgery. Lippincott Williams & Wilkins. 3rd ed. 2001; CLANCEY, Gary. Percutaneous Kirschner-wire fixation of Colles fractures. A prospective study of thirty cases. En: The Journal of Bone and Joint Surgery. Needham. Vol 66. Issue 7. Págs 1008-1014. Año 1984.; BUIJZE, Geert. RING, David. Clinical Impact of United Versus Nonunited Fractures of the Proximal Half of The Ulnar Styloid Following Volar Plate Fixation of th Fistal Radius. En: The Journal of Hand Surgery. Vol 35A. Págs. 223 – 227. Año 2010.; NAKAMURA, Toshiyasu. MOY, Owen. Session 11: Forearm and Wirst 3. Relationship Betweewn the Ulnar Styloid Fracture and DRUJ Instability. En: The Journal of Hand Surgery. Vol 28B. Supplement 1. Pág 48.; MAY, Megan. LAWTON, Jeffrey. BLAZAR. Philip. Ulnar Styloid Fractures Associated With Distal Radius Fractures: Incidence and Implications for Distal Radioulnar Joint Instability. En; Journal of Hand Surgery. Vol 27A. Pásgs 965 – 971. Año 2002.; PROTOPSALTIS, Themistocles. RUSH, David. Triangular Fibrocartilage Complex Tears Associated With Symptomatic Ulnar Styloid Nonunios. En: The Journal of Hand Surgery. Vol 35A. Págs. 1251 – 1255. Año. 2010.; SAMMER, Douglas. SHAH, Hriday. The Effect of Ulnar Styloid Fractures on Patient-Rated Outcomes After Volar Locking Plating of Distal Radius Fracutres. En: The Journal of Hand Surgery. Vol. 34A. Págs. 1595 – 1602. Año. 2009.; ROYSAM, G. The Distal Radioulnar Joint in Colle´s Fractures. En: The Journal of Bone and Joint Surgery. Vol. 75B. Págs. 58-60. Año 1993.; Rikli DA, Regazzoni P. The double plating technique for distalradius fractures. J Bone Joint Surg-B 1996; 78B: 588-92.; Orbay J. Volar plate fixation of distal radius fractures. Hand Clin 2005;21(3): 347e54.; Lattmann T, Meier C, Dietrich M, Forberger J, Platz A. Results of volar locking plate osteosynthesis for distal radius fractures. J Trauma 2011 June;70(6): 1510e8.; Rozental TD, Blazar PE. Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius. J Hand Surg Am 2006 March;31(3):359e65.; Arora R, Lutz M, Hennerbichler A, Krappinger D, Espen D, Gabl M. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma 2007 May;21(5):316e22.; . Stoffelen D, De Smet L, Broos P. The importance of the distal radioulnar joint in distal radius fractures. J Hand Surg Br 1998 August;23(4):507e11.; Geissler WB, Fernandez DL, Lamey DM. Distal radioulnar joint injuries associated with fractures of the distal radius. Clin Orthop Relat Res 1996 June;327: 135e46.; Shaw JA, Bruno A, Paul EM. Ulnar styloid fixation in the treatment of posttraumatic instability of the radioulnar joint: a biomechanical study with clinical correlation. J Hand Surg Am 1990 September;15(5):712e20.; Zenke Y, Sakai A, Oshige T, Moritani S, Nakamura T. The effect of an associated ulnar styloid fracture on the outcome after fixation of a fracture of the distal radius. J Bone Jt Surg Br 2009 January;91(1):102e7.; Souer JS, Ring D, Matschke S, Audige L, Marent-Huber M, Jupiter JB, AOCID Prospective ORIF Distal Radius Study Group. Effect of an unrepaired fracture of the ulnar styloid base on outcome after plate-and-screw fixation of a distal radial fracture. J Bone Jt Surg Am 2009 April;91(4):830e8.; Kim JK, Koh YD, Do NH. Should an ulnar styloid fracture be fixed following volar plate fixation of a distal radius fracture? J Bone Jt Surg Am 2010 January;92(1):1e6.; Itadera E, Kunishi T, Kuniyoshi K. Wiring for ulnar styloid fractures associated with distal radius fractures. J Jpn Soc Surg Hand 2006;23(6):875e7 [in Japanese].; Buijze GA, Ring David. 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 February;35:223e7.; Sawada H, Shinohara T, Natsume T, Hirata H. Clinical effects of internal fixation for ulnar styloid fractures associated with distal radius fractures: A matched case-control study. J Orthop Sci. 2016 Nov;21(6):745-748.; Wijffels MM, Kaizer J, Buijze GA, Zenke Y. Ulnar styloid process nounion and outcome in patients with distal Radius fracture: a Meta- analysis comparativa clínica trials. Injury 2014.
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- application/pdf, Spanish
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- Electronic Resource
- Accession number :
- edsoai.on1090766358
- Document Type :
- Electronic Resource