MANUAL MINORS
A fracture of the radial styloid process is an injury affecting the bony prominence located at the distal end of the radius, near the wrist joint. This fracture may occur in isolation or accompany other distal radius fractures or ligament injuries. It typically results from a fall onto an outstretched hand, and the severity of the injury depends on the displacement and associated instability of the radiocarpal joint.
Diagnosis
The diagnosis is based on:
Localised pain on the radial side of the wrist, specifically at the styloid process.
Swelling and tenderness in the distal radius region, with possible limitation of wrist movement.
X-rays are essential to confirm the fracture and assess its displacement. In more complex cases or when joint instability is suspected, a CT scan may be required.
Differential Diagnosis
Condition | Key Differences |
|---|---|
Colles’ Fracture | Fracture of the distal radius with dorsal displacement of the distal fragment. |
Wrist Sprain | Pain without evidence of bone fracture on X-rays. |
Scaphoid Fracture | Pain in the anatomical snuffbox without involvement of the radial styloid process. |
Fracture of the Ulnar Styloid Process | Pain on the ulnar side of the wrist, with a visible fracture of the ulnar styloid process. |
Emergency Management
Immediate immobilisation of the wrist with a splint or cast to prevent further displacement of the fragment.
Application of ice to reduce swelling and analgesics for pain control.
X-rays to confirm the fracture and assess the extent of the injury.
In non-displaced fractures, immobilisation is usually sufficient, but in cases of significant displacement, reduction may be required.
Definitive Treatment
Treatment depends on the type and severity of the fracture:
Non-displaced fractures: Managed with immobilisation in a cast or splint for 4-6 weeks.
Displaced or unstable fractures: May require surgical fixation with screws or pins to restore alignment and prevent long-term complications such as radiocarpal joint instability.
Rehabilitation is crucial after immobilisation or surgery to restore wrist mobility and function. Complications include stiffness, joint instability, or chronic pain if not properly treated.
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