Name of the Procedure:

Open Treatment of Ulnar Styloid Fracture

Summary

The open treatment of an ulnar styloid fracture involves surgically exposing and repairing a broken ulnar styloid, a bony prominence at the wrist end of the ulna bone in the forearm. This procedure is necessary when the bone does not heal properly with non-surgical methods.

Purpose

This procedure addresses fractures of the ulnar styloid that have not healed correctly or are causing symptoms. The goal is to stabilize and properly align the bone to promote healing, restore wrist function, and alleviate pain.

Indications

• Severe pain or instability in the wrist
• Visible deformity or abnormal movement in the wrist
• Failure of a fracture to heal with conservative treatments like casting or splinting
• Presence of associated injuries requiring surgical intervention

Preparation

• Patients may be required to fast for a certain period before the surgery.
• Medication adjustments may be needed, particularly for blood thinners.
• Preoperative imaging tests such as X-rays or MRI scans to plan the surgical approach.
• Discussion of medical history and any allergies with the healthcare team.

Procedure Description

1. Administration of anesthesia to ensure the patient is comfortable and pain-free.
2. An incision is made over the ulnar styloid to expose the fracture.
3. The fracture is realigned, and hardware such as screws, plates, or wires may be used to secure the bone fragments.
4. The incision is closed with sutures or staples, and a dressing is applied.
5. The wrist may be immobilized with a cast or splint post-surgery.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity of the fracture.

Setting

The procedure is usually performed in a hospital or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection at the surgical site
• Bleeding or blood clots
• Nerve or blood vessel damage
• Nonunion or malunion of the fracture
• Hardware irritation or failure
• Reduced wrist motion or stiffness

Benefits

• Alleviation of pain and discomfort
• Improved wrist stability and function
• Enhanced bone healing
• Reduced risk of long-term complications associated with untreated fractures

Recovery

• Patients may need to wear a cast or splint for several weeks.
• Physical therapy may be required to regain wrist function and strength.
• Most patients can expect to resume normal activities within a few months.
• Follow-up appointments are necessary to monitor healing progress.

Alternatives

• Non-surgical treatments like casting or splinting, which may be suitable for less severe fractures.
• Closed reduction and percutaneous pinning, an alternative minimally invasive procedure.
• Pros: Non-surgical options have lower risk; Cons: May not provide sufficient stability for complex fractures, longer healing time.

Patient Experience

• Patients will be under anesthesia during the procedure and should not feel pain.
• Postoperative discomfort can be managed with pain medication.
• Swelling and bruising around the surgical site are common but typically subside within a few days.
• Patients may experience temporary wrist stiffness or weakness during the recovery period.