From the Research
A wrist brace alone is not suitable for treating an ulnar styloid fracture, and the recommended treatment typically involves a short arm cast for 4-6 weeks, followed by a removable splint and gradual rehabilitation. The treatment of ulnar styloid fractures is crucial for proper bone healing and to prevent chronic pain, weakness, or limited range of motion. According to the most recent and highest quality study, non-surgically treated patients had better wrist function at 6 months 1. However, this does not necessarily mean that a wrist brace is sufficient for treatment.
Ulnar styloid fractures require proper alignment and immobilization to heal correctly because this bone plays an important role in wrist stability and forearm rotation. Without adequate immobilization, the fracture may heal improperly, leading to chronic pain, weakness, or limited range of motion. For displaced fractures or those with instability, surgical fixation with pins, screws, or wires may be necessary. While a wrist brace might be used during the later stages of recovery after cast removal, it doesn't provide the rigid immobilization needed for proper bone healing in the initial treatment phase.
Some studies suggest that accompanying ulnar styloid fractures may worsen the functional outcomes after plate fixation of distal radius fractures 2. Early detection and surgical repair yielded better outcomes, and higher complication rates in late-treated fractures show that surgeons should select surgical candidates and modalities properly 3. The treatment of isolated ulnar fractures in adults is also controversial, with different authors recommending both surgical and non-surgical management 4. However, the most recent study suggests that non-surgical treatment can be effective in certain cases 1.
In terms of specific treatment options, tension band wiring was used for surgically treated USP fractures, and results were comparable across the different study designs 1. Other techniques, such as K-wire fixation and suture anchor, have also been compared in terms of their effects on forearm rotation and dorsal-palmar translation of the DRUJ 5.
Anyone with a suspected ulnar styloid fracture should seek medical evaluation from an orthopedic specialist who can provide appropriate imaging, diagnosis, and a tailored treatment plan based on the fracture characteristics and patient factors. The key to successful treatment is to prioritize proper alignment and immobilization, and to select the most appropriate treatment modality based on the individual case.