Introduction:
Athletes are at higher risk of ulnar styloid fracture due to increased force. They also increase their activity level compared to non-athletes. Athletes involved in sports like basketball, volleyball, or cricket have more chances of ulnar styloid fractures. It is a painful condition and also restricts the range of motion. Therefore, it is important to identify at-risk athletes so they can take necessary precautions before sustaining an injury. After sustaining an ulnar styloid fracture, it is necessary to immobilize the injured hand in a cast for three weeks to ensure proper healing and that further injuries do not occur. A rehabilitation program is also important after the primary treatment. To increase the range of motion and reduce the stiffness.
What Is an Ulnar Styloid Fracture?
The human forearm has two bones named ulna and radius. The ulna bone is present on the outside of the wrist, and the radius is present on the inside of the wrist. The ulnar styloid process is a bony projection located at the endpoint of the ulna. This ulnar styloid projection bonds with the cartilages of the joints of the wrists. This bond helps in increasing the strength of the wrist and maintains flexibility. Injury while playing or other trauma results in ulnar or styloid bone breaking, known as an ulnar styloid fracture.
What Are the Symptoms of Ulnar Styloid Fractures?
Fractures in ulnar styloid bones have the following symptoms -
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Immediate pain in the area of fractures.
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If ulnar styloid fractures are combined with radius fractures, it can cause pain in the inner side of the wrist in the area of the ulnar styloid process.
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Tenderness.
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Swelling in the fractured area.
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Bruising in the area of the fracture.
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Limited range of motion.
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Severe cases can cause changes in the angle of the hand and wrist.
What Are the Causes of Ulnar Styloid Fractures?
The common causes of ulnar styloid fractures are listed below -
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Motor vehicle accidents.
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Falls with outstretched hands.
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Injury during sports like while playing volleyball, basketball, or catching balls.
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Fights with bare hands.
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People suffering from osteoporosis have weak bones and are more prone to fractures. These people need to be aware of all preventive measures to avoid breaking bones.
How to Diagnose Ulnar Styloid Fractures?
To diagnose an ulnar styloid fracture, healthcare professionals use the following steps:
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Examining the Patient’s Medical History and Physical Condition: The health care professional will start asking about the patient's symptoms and medical history. They will then perform a physical examination, assessing the affected wrist for pain, tenderness, swelling, deformity, and limited range of motion.
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X-Ray Imaging: X-rays are commonly used to evaluate suspected ulnar styloid fractures. Different views (Anteroposterior (AP) and lateral views) of the wrist are taken to visualize the bones and detect any fractures or abnormalities.
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Stress Views or Dynamic Ulnar Deviation: In some cases, the doctor may perform stress views or dynamic ulnar deviation X-rays to assess stability and determine if any ligamentous injury is associated with the fracture.
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Computed Tomography (CT) Scan: In complex or severe cases, a CT scan and may be ordered to obtain more detailed images of the fracture, especially if there is suspicion of displacement, comminution (broken in multiple pieces), or involvement of other structures.
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Magnetic Resonance Imaging (MRI): In certain situations, an MRI may be recommended to assess soft tissue structures, such as ligaments, tendons, and cartilage, especially if there is concern about associated injuries or persistent symptoms despite initial treatment.
Consult with a healthcare professional for diagnosis. They will assess the situation, order the appropriate imaging tests, and interpret the results to determine if an ulnar styloid fracture is present and guide further treatment decisions.
What Is the Treatment of Ulnar Styloid Fractures?
Fracture bones require positioning back in the right place. Ulnar styloid fractures can be treated with both conservative and surgical treatment.
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Nonsurgical Treatment - Cases of mild ulnar styloid fractures require a cast for three weeks. Before placing the wrist under the cast, the doctor will perform closed reduction (repositioning the bones in the right alignment). A centralization of blood flow promotes faster healing. For this reason, the site of the fracture should be elevated and kept dry to reduce pain and promote healing. Ice should be applied to the wound daily for pain relief and faster healing. Additionally, local anesthetic creams are applied to the fracture sites, and over-the-counter medication can be prescribed for pain relief.
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Surgical Treatment - Severe cases of ulnar styloid fracture require surgical treatment. The doctor will perform the open reduction ( repositioning of the fractured bones in the right position through an incision). Metal screws, plates, and pins are used to align the bones and promote healing. After the open reduction procedure, the arm should be placed inside a cast made of plaster of paris or fiberglass material.
It is important to recommend appropriate exercises after surgically repairing an ulnar styloid fracture. Exercise that causes stress on the injured hand may increase the inflammation of the fractured bone. Horse tendon damage should be avoided post-operatively. Taking a few days off from sports may also be necessary after this allows muscles that have been strained while playing to recover without interfering with the athlete's performance.
How Much Time Does an Ulnar Styloid Fracture Require to Heal?
The healing of an ulnar styloid fracture depends upon the severity of the fracture. If the bones are fractured, then it takes longer to heal. The first symptom people notice swelling in the fractured area (around the wrist). A splint is required for some time; it will be helpful in preventing movements of the wrist. A cast is required for at least three weeks. Sometimes people need to change the casts in the middle of the treatment if they become loose due to loss of swelling. In severe cases of fracture in which surgery is necessary, the doctor places the fractured hand directly in a cast after the open reduction is made. Following this doctor will ask for an X-ray in alternating weeks to check the healing. Most surgical cases require a cast for more than a month.
After the removal of the cast, a physiotherapist will help in rehabilitation. After around one to two months, normal activities can be started. Depending upon the injury, it will take around three to six months to return fully to the respected sports or work. Full recovery of severe ulnar styloid fracture can take more than one year to heal. Postoperative stiffness in muscles and bones is common, and it takes almost two years to heal.
Conclusion:
Ulnar styloid fractures are quite common in athletes. These fractures occur due to injury or trauma to the associated bones. Any breaks in ulnar or styloid bones are known as ulnar styloid fractures. Both conservative and surgical treatments are available for ulnar styloid fractures. After an athlete sustains an ulnar styloid fracture, proper recovery is crucial. Hospitalization may be required if primary healing does not occur within three weeks despite proper post-surgical exercises and treatment. Elevating the fracture site prevents excessive swelling after surgery and allows for faster healing. Also, identifying at-risk athletes and taking precautions can help to reduce the risk of additional injury.
