Complications

Radial styloid fracture management should consider the spectrum of associated injuries, and when surgery is indicated, incisions should be chosen to minimize soft tissue problems. Patient demands, bone quality, and other mitigating circumstances will temper the treatment logic for each individual. Postoperative complications are increased with the degree of invasiveness chosen for a particular injury pattern.

Acute carpal tunnel syndrome is not common with radial styloid fractures, and some median nerve dysfunction may be from nerve contusion rather that intracanal swelling. Complications from median nerve decompression are rare, and release of the carpal tunnel should be performed liberally when median nerve function is compromised.

Percutaneous pin placement may be done through small incisions with blunt dissection to avoid sensory nerve irritation. Likewise, arthrotomy and arthroscopic portal sites should be carefully developed to lessen the risk of neuroma formation. Infection is rare with surgical management of radial fractures. Joint stiffness is very common, especially after surgical management and is proportional to the invasiveness of the procedure(s).

Predictable osteoarthritic changes may follow even when an accurate diagnosis is made and an appropriate treatment plan are instituted for scapholunate ligament injuries arising in conjunction with radial styloid fractures. Management depends on the arthritic stage of the wrist when the symptoms develop. Static scapholunate dissociation is difficult to manage even when radioscaphoid arthritic changes are minimal. Likewise, when radioscaphoid arthritis develops, proximal row carpectomies and limited intercarpal fusions may provide pain relief if the radiolunate articulation is spared of arthritic change.

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