Treatment of Type 2 Symptomatic Ulnar Styloid Nonunions with Reinsertion of the Triangular Fibrocartilage Complex

Purpose: The purpose of this retrospective study was to introduce an alternative technique for the treatment of type 2 symptomatic ulnar styloid nonunion by reinsertion of triangular fibrocartilage complex and ulnar collateral ligament. Methods Between March 2009 and May 2017, 45 patients who suffered nonunion of the type II ulnar styloid fractures were enrolled. All patients underwent subperiosteal resection of the avulsed fragments and reinsertion of the TFCC and ulnar collateral ligament. Outcome assessments included range of the motion of the wrist, grip strength, pain, and Mayo wrist score. The preoperative and postoperative parameters were compared. A P value less than 0.05 was considered statistically significant. Result The mean follow-up period was 21.66 ± 7.93 months (range, 12 to 26 months). At the final follow-up, the mean preoperative flexion and extension were 79.32 ± 4.52° and 74.40 ± 4.36°, respectively. The mean preoperative pain score, grip strength, Mayo wrist score were 32.48 ± 4.00; 23.88 ± 8.38 kg, and 77.72 ± 8.31, respectively. The mean postoperative flexion and extension of the wrist were 80.56 ± 6.32° and 75.43 ± 3.12°, respectively. The mean postoperative pain score, grip strength, Mayo wrist score were 12.41 ± 3.27, 26.31 ± 8.30 kg, and 90.71 ± 7.97, respectively. There were significant differences with respect to pain, grip strength, and Mayo wrist score (P < 0.05), but no significant differences with respect to range of motion of the wrist. Conclusion In the treatment of nonunion of the type II ulnar styloid fractures, resection of the avulsed fragments followed by reinsertion the TFCC and ulnar collateral ligament with an anchor was a reliable alternative technique, resulting in satisfactory function of the wrist.