True Symphalangism of All Bilateral Proximal Interphalangeal Joints with Multi-carpal Coalition and Hypoplasia of the Ulnar Styloid Process

Symphalangism is a rare genetic condition characterized by ankylosis of the proximal interphalangeal (PIP) or/and distal interphalangeal (DIP) joints. The patient presented with fused bilateral PIP joints and poor flexion, and an unsatisfactory range of motion (ROM) in the metacarpophalangeal (MP) and DIP joints. Concomitantly, multi-carpal coalition, proximal carpal malalignment, and ulnar styloid process abnormality were also observed in radiographs obtained at diagnosis. Rehabilitation training of the MP and DIP joints and a wrist supporter were recommended to achieve MP and DIP functional motion and restrict dramatic wrist motion. This is the first case report of symphalangism with multi-carpal coalition and abnormality of the ulnar styloid process to the best of our knowledge.

Ankle lesions and shortening of the forearm on a female from the Roman city of Augusta Emerita (Mérida, Spain): consequences of an accidental traumatic episode during growth?

In one Roman funerary area (1st-2nd centuries AD) of Augusta Emerita, an adult female skeleton was found, showing multiple healed trauma, being one the first evidences of this kind documented in the capital of Lusitania. This study describes those lesions, reconstructs the possible events responsible and hypothetical impact on the subject’s quality of life. Macroscopic and radiological observation revealed fractures of the left distal third of the radius and the ulnar styloid process, as well as of the distal third of the left fibula. Those of the forearm, caused a shortening of about one centimetre, probably resulting from a fall during growth. The fracture of the fibula would have occurred from an underfoot accident resulting also in a heterotopic ossification of the distal anterior ligament. Since both fractures are well consolidated and without degenerative articular lesions, this woman probably did not suffer significant sequelae thereafter.

Lag Screw Fixation for Treatment of an Ulnar Styloid Process Fracture with Antebrachiocarpal Joint Luxation in a Cat

Fracture of the ulnar styloid process can result in clinically debilitating antebrachiocarpal instability. Previously described repair methods include Kirschner wire and figure of eight tension band wire and/or intramedullary pinning. This case report describes surgical repair of a short oblique ulnar styloid process fracture in a cat using two cortical screws placed in lag fashion. Recheck evaluation confirmed lameness-free full return to function with anatomical fracture healing.

Isolated Salter-Harris Type III Physeal Fracture of the Distal Ulna

We describe a case of isolated physeal fracture of ulna distal end in a 13-year-old boy. This fracture type is uncommon, especially Salter-Harris type III of this injury has not been reported. Plain radiographs showed a small vertical fracture line at the ulnar distal end and an enlargement of epiphyseal plate at the base of ulnar styloid process. The present case was successfully managed with conservative treatment because of its minimal displacement.

Functional outcomes of distal radius fractures with and without ulnar styloid fractures: a meta-analysis

The aim of this meta-analysis was to compare the functional outcomes of patients with a distal radius fracture with and without a concomitant fracture of the ulnar styloid process. A systematic literature search was performed to identify all studies comparing patients with a distal radius fracture with and without an ulnar styloid process fracture. The initial search revealed 511 articles, of which 12 articles with a total of 2243 patients were included; 1196 patients with and 1047 patients without an ulnar styloid process fracture. A statistically significant mean difference of 3.40 points (95% CI 1.33–5.48) in the Disability of the Arm, Shoulder, and Hand score was found in favour of patients without an ulnar styloid process fracture. This difference is less than 10 and therefore not clinically important. No significant difference was found in Patient-Rated Wrist Evaluation scores, range of motion, grip strength, visual analogue scale pain scores, ulnar-sided wrist pain and distal radio-ulnar joint instability between patients with and without an ulnar styloid process fracture after 1 year of follow-up. Moreover, no significant differences were found between ulnar styloid base and nonbase fractures. Level of evidence: I