CLASSIFICATION AND TREATMENT OF ULNAR STYLOID NONUNION

Symptomatic nonunion of the ulnar styloid is an uncommon problem that is usually best treated by simple excision of the ulnar styloid Fragme nt. Two types of nonunion of the ulnar styloid are described here on a n anatomic basis, and their treatment differs. Type 1 is defined as a nonunion associated with a stable distal radioulnar joint. Type 2 is d efined as a nonunion associated with subluxation of the distal radioul nar joint. The postoperative follow-up period for the two types ranged from 4 months to 13 years, with a mean of 5 years 2 months. Eleven ty pe 1 wrists were treated with excision of the fragment, and ail patien ts had satisfactory relief of pain. Nine type 2 wrists required restor ation of the anatomy of the triangular fibrocartilage complex. Three o f these had large fragments that were treated by open reduction and in ternal fixation. All three patients were completely relieved of their discomfort. Six other patients underwent excision of the fragment and repair of the triangular fibrocartilage complex to the distal ulna. Th is group had four excellent, one good, and one fair result. If the dis tal radioulnar joint is stable on presentation or if its stability is restored, then long-term relief of pain from ulnar styloid nonunion is achieved by treatment of the nonunion.