Abstract
Background: Ulnar sided wrist pain is one of the most common complications of distal radius fractures. The simplest method for decreasing pain for this affliction is corticosteroid injection. The present study was designed to assess the effect of corticosteroid injection in the prevention of ulnar sided wrist pain.
Materials and Methods: In this clinical trial patients with distal radius fractures scheduled for closed reduction and percutaneous pin fixation were divided into control and corticosteroid groups. In the corticosteroid group, the patient received a single betamethasone injection in the dorsoulnar side of the wrist before reduction, while the control group received placebo. The patients were to be followed for at least 6 months.
Results: 82 patients were followed for 6 months. At the end of the 3 months followup the difference between the two groups about the number of individuals without ulnar sided wrist pain was statistically significant (P = 0.038), so that less patients in the control group were painless, while this was not the case in the 6 months followup (P = 0.507), but in the both time frames the mean grip power, visual analog pain score and the disabilities of the arm, shoulder and hand (DASH) score showed statistically significant difference between the two groups, so that the corticosteroid groups demonstrated greater power grip and less scores in pain and DASH (P < 0.05).
Conclusion: Based on the findings of the present study it seems that prophylactic corticosteroid injection will be associated with a decrease in the severity of wrist pain in patients with acute distal radius fractures. With regard to the decrease in the number of painless individuals, it seems that the decrease is not persistent. Overall the need for a study with longer followup is obvious.
Similar content being viewed by others
References
Nellans KW, Kowalski E, Chung KC. The epidemiology of distal radius fractures. Hand Clin 2012;28:113–25.
Altissimi M, Antenucci R, Fiacca C, Mancini GB. Long term results of conservative treatment of fractures of the distal radius. Clin Orthop Relat Res 1986;202–10.
Roumen RM, Hesp WL, Bruggink ED. Unstable Colles’ fractures in elderly patients. A randomised trial of external fixation for redisplacement. J Bone Joint Surg Br 1991;73:307–11.
Cheng HS, Hung LK, Ho PC, Wong J. An analysis of causes and treatment outcome of chronic wrist pain after distal radial fractures. Hand Surg 2008;13:1–10.
Tsukazaki T, Iwasaki K. Ulnar wrist pain after Colles’ fracture 109 fractures followed for 4 years. Acta Orthop Scand 1993;64:462–4.
Zyluk A, Piotuch B. Distal radioulnar joint instability: A review of literature. Pol Orthop Traumatol 2013;78:77–84.
Krämer S, Meyer H, O’Loughlin PF, Vaske B, Krettek C, Gaulke R. The incidence of ulnocarpal complaints after distal radial fracture in relation to the fracture of the ulnar styloid. J Hand Surg Eur Vol 2013;38:710–7.
Belloti JC, Moraes VY, Albers MB, Faloppa F, Dos Santos JB. Does an ulnar styloid fracture interfere with the results of a distal radius fracture? J Orthop Sci 2010;15:216–22.
Zhao L, Wang BJ, Li YD, Yu HS, Liu ZY, Gao H, et al. Clinical followup study of ulnar styloid fractures and classification of distal radial fractures. Beijing Da Xue Xue Bao 2011;43:675–80.
Scheer JH, Adolfsson LE. Radioulnar laxity and clinical outcome do not correlate after a distal radius fracture. J Hand Surg Eur Vol 2011;36:503–8.
Kim JK, Koh YD, Do NH. Should an ulnar styloid fracture be fixed following volar plate fixation of a distal radial fracture? J Bone Joint Surg Am 2010;92:1–6.
Chen YX, Zheng X, Shi HF, Wangyang YF, Yuan H, Xie XX, et al. Will the untreated ulnar styloid fracture influence the outcome of unstable distal radial fracture treated with external fixation when the distal radioulnar joint is stable. BMC Musculoskelet Disord 2013;14:186.
Hauck RM, Skahen J 3rd, Palmer AK. Classification and treatment of ulnar styloid nonunion. J Hand Surg Am 1996;21:418–22.
Buijze GA, Ring D. Clinical impact of united versus nonunited fractures of the proximal half of the ulnar styloid following volar plate fixation of the distal radius. J Hand Surg Am 2010;35:223–7.
Watanabe A, Souza F, Vezeridis PS, Blazar P, Yoshioka H. Ulnar-sided wrist pain. II. Clinical imaging and treatment. Skeletal Radiol 2010;39:837–57.
Buterbaugh GA, Brown TR, Horn PC. Ulnar-sided wrist pain in athletes. Clin Sports Med 1998;17:567–83.
Hull P, Baraza N, Gohil M, Whalley H, Mauffrey C, Brewster M, et al. Volar locking plates versus K-wire fixation of dorsally displaced distal radius fractures–A functional outcome study. J Trauma 2011;70:E125–8.
Karantana A, Downing ND, Forward DP, Hatton M, Taylor AM, Scammell BE, et al. Surgical treatment of distal radial fractures with a volar locking plate versus conventional percutaneous methods: A randomized controlled trial. J Bone Joint Surg Am 2013;95:1737–44.
Grewal R, MacDermid JC, King GJ, Faber KJ. Open reduction internal fixation versus percutaneous pinning with external fixation of distal radius fractures: A prospective, randomized clinical trial. J Hand Surg Am 2011;36:1899–906.
Kurimoto S, Tatebe M, Shinohara T, Arai T, Hirata H. Residual wrist pain after volar locking plate fixation of distal radius fractures. Acta Orthop Belg 2012;78:603–10.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Saied, A., Heshmati, A., Sadeghifar, A. et al. Prophylactic corticosteroid injection in ulnar wrist pain in distal radius fracture. IJOO 49, 393–397 (2015). https://doi.org/10.4103/0019-5413.159595
Published:
Issue Date:
DOI: https://doi.org/10.4103/0019-5413.159595