A COMPARITIVE STUDY OF FUNCTIONAL OUTCOME OF DISPLACED ULNAR STYLOID FRACTURES TREATED CONSERVATIVELY VS OPERATIVELY ASSOCIATED WITH DISTAL END RADIUS FRACTURES TRETAED SURGICALLY

Abstract

Introduction: Ulnar styloid fractures, a common injury associated with distal radius fractures, are often a subject of debate regarding their optimal management. The ulnar styloid process, situated at the distal end of the ulna, plays a significant role in the stability and function of the wrist joint, particularly influencing the function of the triangular fibrocartilage complex (TFCC). Surgical repair and conservative treatment are two major management strategies widely adopted in ulnar styloid fracture patients, but the consensus of the optimal treatment strategy is still debated. Aim and objective: The aim of this study is to assess potential differences in clinical and radiological outcomes between surgical and conservative management of ulnar styloid fractures that occur alongside distal radius fractures treated with volar plating. This evaluation will focus on the duration of fracture union and the PRWE (Patient-Rated Wrist Evaluation) score. Materials and Methods: Group A underwent conservative management and Group B underwent surgical management for ulnar styloid fracture while distal end radius fracture was operated with volar plating for both the groups.Each group has 20 patients of distal end radius fracture with ulnar styloid fracture. Patient follow up was carried at 1.5 months , 3 months and 6 months and were clinically and radiologically assessed and outcomes were graded according to PRWE Score. Results: A significant difference was observed in non-union between 2 groups with non union occurring in 45% of conservative cases, compared to 15% in the operative group .Functional outcome assessed using mean changes in the PRWE score which was 27.96 ± 10.90 for rotella type 1, 22.21 ± 7.10 for type 2, 30.77 ± 8.19 for type 3 in Group A while 20.28 ± 12.13in rotella type 1, 14.73 ± 7.64 in type 2, 22.36 ± 8.40 in rotella type 3 in Group B at 6 months follow up. Conclusion: Patients who underwent operative treatment for ulnar styloid fractures showed a statistically significant improvement in functional outcomes using PRWE Score compared to those who were treated conservatively. The incidence of complications like non-union was higher in the conservative treatment group. Radiological union of the ulnar styloid fracture was achieved more consistently and predictably in the operative group.