What bone fracture is most commonly associated with an acute right distal radius fracture with dorsal displacement?

From the Guidelines

The ulnar styloid fracture is most commonly associated with an acute right distal radius fracture with dorsal displacement. This combination occurs in approximately 50-60% of distal radius fractures, particularly those resulting from a fall on an outstretched hand (FOOSH injury) 1. When the distal radius fractures and displaces dorsally (often called a Colles' fracture), the force is transmitted through the triangular fibrocartilage complex to the ulnar styloid, causing it to fracture as well.

This association is important to recognize clinically because the presence of an ulnar styloid fracture may affect treatment decisions and outcomes. Patients with both injuries may experience more wrist instability, longer recovery times, and potentially more complications if the ulnar styloid fracture is displaced or involves the base where the triangular fibrocartilage complex attaches. Some key points to consider in the management of such injuries include:

• The potential for increased wrist instability and complications
• The need for monitoring the ulnar styloid fracture for proper healing and potential disruption of the distal radioulnar joint stability
• The importance of addressing any persistent ulnar-sided wrist pain that may arise from an improperly healed ulnar styloid fracture or disrupted distal radioulnar joint stability 1.

Treatment typically focuses primarily on the distal radius fracture, but the ulnar styloid fracture should be monitored as it may contribute to persistent ulnar-sided wrist pain if it doesn't heal properly or if it disrupts the stability of the distal radioulnar joint.

From the Research

Fracture Association

• The fracture most commonly associated with an acute right distal radius fracture with dorsal displacement is the ulnar styloid fracture 2, 3, 4, 5, 6.

Characteristics of Ulnar Styloid Fracture

• Ulnar styloid fractures often occur in association with distal radial fractures 3.
• The presence of an ulnar styloid fracture does not significantly affect the outcome of an adequately fixed distal end radius fracture 2, 3.
• Minor and slightly displaced ulnar styloid injuries do not require separate treatment at distal radius fractures 6.

Treatment and Outcome

• Stable fixation of a distal radial fracture has no apparent adverse effect on wrist function or stability of the distal radioulnar joint, even with an accompanying ulnar styloid fracture 3.
• Treatment of the distal radius fracture is essential for the final anatomical and functional outcome, while ulnar styloid fracture or union are of lesser importance 6.