Name of the Procedure:

Percutaneous Skeletal Fixation of Ulnar Styloid Fracture

Summary

Percutaneous skeletal fixation of an ulnar styloid fracture is a minimally invasive surgical technique used to stabilize and repair a broken ulnar styloid, a small bony prominence at the wrist end of the ulna bone in the forearm.

Purpose

This procedure addresses fractures of the ulnar styloid. The goal is to stabilize the fracture, promote proper healing, and restore function to the wrist and forearm.

Indications

• Fracture of the ulnar styloid.
• Persistent pain and instability of the wrist due to the fracture.
• Nonunion or malunion of a previously fractured ulnar styloid.
• Wrist instability affecting daily activities.

Preparation

• Patient may need to fast for a few hours before the procedure.
• Adjustments to current medication regimen, particularly blood thinners.
• Diagnostic imaging (X-rays or CT scans) to assess the fracture.
• Preoperative assessment to determine overall health and anesthesia risk.

Procedure Description

1. The patient is positioned appropriately, typically with the arm accessible.
2. Local or regional anesthesia is administered.
3. Under fluoroscopic guidance, small incisions are made near the fracture site.
4. Specialized instruments are used to align the fractured bone fragments.
5. Pins, screws, or wires are inserted through the skin and into the bone to secure the fragments.
6. The fixation devices are adjusted to ensure proper alignment of the bone.
7. The incisions are closed with sutures or adhesive strips, and a sterile dressing is applied.

Duration

The procedure typically takes about 30-60 minutes.

Setting

Usually performed in a hospital or surgical center, often on an outpatient basis.

Personnel

• Orthopedic surgeon
• Anesthesiologist (if general anesthesia is used)
• Surgical nurse
• Radiologic technologist for imaging support

Risks and Complications

• Infection
• Damage to nerves or blood vessels
• Nonunion or delayed healing of the fracture
• Migration or loosening of fixation devices
• Pain or discomfort at the fixation sites

Benefits

• Stabilization and proper alignment of the fracture.
• Faster and more reliable healing.
• Restoration of normal wrist function.
• Outpatient nature allows for quicker recovery in the home environment.

Recovery

• Initial rest and immobilization of the wrist.
• Pain management with medications.
• Gradual increase in activities as tolerated.
• Physical therapy may be recommended.
• Follow-up visits to monitor healing and remove fixation devices if necessary.
• Full recovery may take several weeks to a few months.

Alternatives

• Conservative management with immobilization (casting or splinting), which may be suitable for less severe fractures.
• Open reduction and internal fixation (more invasive surgical option).
• Orthopedic braces to provide support and facilitate healing.

Patient Experience

• Mild discomfort and pain managed with medications post-procedure.
• Temporary restriction in wrist and forearm movements.
• Outpatient procedure allows for return home the same day.
• Physical therapy to regain strength and mobility.
• Follow-up care to monitor healing progress and timely removal of fixation devices.