The radius is represented by a paired formation located next to the ulna, but more anterior and slightly outward from it. What is the styloid process of the radius? In Latin, they call it like this - processus styloideus.
What is this process
This is a formation in the region of the lower (distally located) epiphysis, epiphysis distalis, it is thickened in the direction of the frontal plane. It is from this part that the processus stuloideus radii departs and is perfectly palpable.
How common is a fracture of the styloid process of the radius?
Traumatization of this area is high, accounting for about 50% of the total number of fractures. Most often this occurs when falling on an outstretched hand. Moreover, it is much more common in females than in men. This occurs as a result of hormonal changes in the body of a woman, the processes of demineralization of bone tissue, which leads to the development of osteoporosis.
Causes of fractures
Causes of styloid fracturesradius are as follows:
- Participation in a traffic accident (RTA).
- In winter, especially when there is ice.
- Falling onto a hand from a bicycle, rollerblades, roof.
- Sports.
- Performing various kinds of sports and extreme stunts.
- Participation in active games.
Types of fractures
Fractures can be of several types:
- Compression type.
- Tear-off type.
Compression type
More often occurs after a blow to the area of the wrist of the hand, due to which the energy flow of the impact movement pulls the styloid process of the radius outward and slightly backward, after which it spreads to the adjacent navicular bone and causes a fracture of this articulating part of the surface. As a result, a linear fracture occurs at the junction of the navicular and lunate bones in the form of a crack, so there is no displacement of the fragments.
It is necessary to reposition (comparison) of bone fragments, which is carried out by closed access under local anesthesia.
Clinical picture
The following symptoms are observed:
- Significant swelling with spread to underlying tissues. It may seem that the skin of this area is as if stretched, there is a significantly pronounced feeling of discomfort.
- Severe soreness.
- Movement restrictionboth active (more pronounced) and passive (less pronounced).
- The sound of crepitus ("crunching", "creaking", as when walking in the snow) when trying to move or move a limb.
- The area of the fracture is hyperemic, sometimes it can be combined with the formation of hematomas.
Diagnostic tests
In the first place is a carefully collected history of the disease from the victim. In second place is an x-ray examination of the injured limb in several projections to determine a more accurate picture of the nature of the fracture of the styloid process of the radius.
Urgent measures
It is necessary to apply cold to the place of damage, it can be a heating pad with ice or just a piece of ice if the first one is not at hand. Since ice has a vasoconstrictive effect, prevents the growth of edema, and also has a less pronounced analgesic effect.
Treatment measures
To carry out reposition, the doctor must take the affected limb so that one hand is on the wrist joint from its inner surface, and the other is taken by the opposite side and tightly squeezes the victim's hand. It is necessary to compress strongly enough so that the fragments take their normal physiological position. Otherwise, a poor-quality repositioning procedure can lead to a malfunction of the limb, and in some cases, it also leads to disability of the patient.
Avulsion of the styloid process of the radius
Bunlike the compression fracture described above, in this case, a complete detachment of the bone element is observed.
This is most commonly seen with a fall on an outstretched hand, in which the wrist deviates inward and the styloid process pulls away from the radius and breaks off. Sometimes this occurs along with a complete dislocation of the wrist joint.
The styloid processes of the radius and ulna are very fragile.
Clinical manifestations
The symptoms of such a fracture are as follows:
- Sharp pain that occurred in the first minutes after the injury when trying to move the injured hand. Therefore, the patient takes the most advantageous and sparing position for this hand.
- A creaking sound is heard due to the friction of bone surfaces against each other.
- Crepitation phenomena.
- Sharply pronounced swelling, accompanied by the formation of hematomas.
Diagnostic measures
When the styloid process of the radius is displaced, the following measures must be taken:
- Collecting anamnesis.
- Examination by a traumatologist.
- X-ray examination in direct and lateral projection of the wrist joint.
- If necessary, additional research methods such as computed tomography (CT) or soft tissue ultrasound (ultrasound) can be performed.
How to treat a fracture of the styloid process of the radius?
Treatment
The most important thing is to carry out bone reposition followed by immobilization with a plaster splint, which is worn for at least one month. Then a second X-ray examination is carried out in order to make sure that the fragments grow together correctly. This is done to ensure maximum mobility in the physiological joints of the composite surfaces.
If necessary, surgical intervention is performed using foreign means of fixation (pins, screws).
Drug therapy consists in the use of vitamin D and calcium-fortified preparations to minimize the period of adequate bone fusion in the rehabilitation period, since with improper treatment, styloiditis of the styloid process of the radius can develop.
First aid
Since it is not always possible to deliver the victim to a medical facility in the first minutes, it is necessary to have an idea about first aid using the available means at hand.
First of all, you need to immobilize (immobilize) the injured limb, fix it with some kind of tissue, apply a splint, this is done in order to prevent complications such as bleeding and displacement, as well as to prevent a more pronounced pain syndrome.
Sanitary treatment is carried out in the presence of a wound surface. For this, any antiseptic, disinfectant solution (hydrogen peroxide or, for example, alcohol iodine solution) is suitable. The solution is applied toany torn piece of cloth or napkin, and the area is processed. This is done in order to decontaminate the fracture wound and prevent infection of various types of pathogenic agents.
Since the patient is worried about a severe pain syndrome, it is necessary to give him analgesic groups of drugs, such as steroidal anti-inflammatory drugs (NSAIDs). The most effective are Diclofenac, Ketoprofen or Ibuprofen.
Plus, in addition to all of the above, we must not forget about the cold, which must be immediately put on the site of the fracture of the styloid process of the radius (photo below).
Rehabilitation activities
Include a set of measures aimed at the speedy fusion of bone surfaces with each other and a faster recovery.
There are physiotherapy procedures, the most effective of which are visits to ultraviolet irradiation (UVR), magnetotherapy and UHF therapy. The latter procedure is contraindicated in surgical interventions with the installation of metal structures.
After a week and a half, visits to infrared laser therapy procedures, pulsed UHF EP combined with magnetic stimulation of damaged nerve fibers are added.
After the removal of the plaster splint, physiotherapy exercises with a visit to the massage course are shown. They stimulate the speedy recovery of lost limb functions by strengthening the neuromuscular apparatus and restoring transmission.electrical impulses from the injured limb and back.
Regarding nutrition, here you also need to take into account that you should eat more those foods that are rich in calcium and vitamin D. This is primarily milk, cottage cheese, sour cream, seafood, hard cheeses, legumes, herbs, dried fruits (dried apricots, prunes), veal, liver, and fish oil.
Terms of rehabilitation
Determined individually depending on the general condition of the body and the presence of complications. But the average is about one and a half months.
Possible Complications
The following consequences may develop with improper treatment:
- Due to the addition of infection at any stage of care. Purulent-septic inflammation develops with a threatening transition to death.
- Loss of the neurovascular bundle, which can lead to the development of contractures (limitations of movement in the joint).
- Incorrect fusion of bones with the formation of a false joint and deformity of the limb as a whole.
- Development of osteomyelitis (purulent-septic lesion of both the bone marrow and the bone apparatus).
- Neurotrophic complications.
- Cosmetic defect in the form of the so-called "bulging" of the styloid process of the radius.
- Various types of deformities of the bone and articular apparatus.
