Ulnar styloid fracture

Last revised by Henry Knipe on 2 Apr 2023

Ulnar styloid fractures occur in association with ~60% of distal radius fractures

Usually, this kind of fracture occurs as the result of a fall on an outstretched arm and is often associated with a distal radius fracture 1.

Most common are small avulsion fractures involving the tip of the ulnar styloid with transverse fractures through the base less common 2.

In the pediatric and adolescent forearm, it should be remembered that in very rare situations the ulnar styloid can arise from a separate ossification center, but mostly separation of the ulnar styloid is caused by injury 1.

The fracture is easy to recognize on plain film. Sometimes the fractures may not seem very apparent on x-ray if there is no displacement.

In children, up to 15% of ulnar styloid process fractures may be occult as the ulnar styloid process does not start to ossify until 5-9 years 2.

In patients with distal radius fractures, a concomitant ulnar styloid fracture does not affect outcomes 3, and a lack of union of these fractures does not significantly affect late functional results 1,2. Fractures at the very base of the ulnar styloid can cause instability of the distal radioulnar joint (DRUJ) and disruption of the triangular fibrocartilage complex (TFCC) insertion at the ulnar fovea. It is argued that these injuries, therefore, need open stabilization 1.

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