The radius is represented by a paired formation located next to the ulna, but more anteriorly and slightly outward from it. What is the styloid process of the radius? In Latin they call it that - processus styloideus.
What is this process
This formation is in the region of the lower (distally located) pineal gland, epiphysis distalis, it is thickened in the direction of the frontal plane. It is from this part that processus stuloideus radii departs and is perfectly palpable.
How often is the styloid bone fracture?
Injury to this site is high, accounting for about 50% of the total number of fractures. Most often this happens when falling on an outstretched arm. Moreover, it is much more common in women 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
The causes of fractures of the styloid process of the radial bone are as follows:
- Participation in a traffic accident (accident).
- In winter, especially in the presence of ice.
- Drop on hand from a bicycle, rollers, roof.
- Doing sports.
- Carrying out various types of sports and extreme stunts.
- Participation in active games.
Varieties of fractures
Fractures can be of several types:
- Compression type.
- Tear-off type.
Compression type
Most often occurs after hitting the wrist, due to which the flow of energy of the shock movement pulls the styloid process of the radial bone outward and slightly back, after which it spreads to the adjacent scaphoid and causes a fracture of this articulating part of the surface. As a result, a linear fracture occurs at the junction of the scaphoid and lunate bones in the form of a crack, so there is no displacement of fragments.
It is necessary to conduct a reposition (comparison) of bone fragments, which is carried out with closed access using 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, a significantly pronounced feeling of discomfort is felt.
- Severe soreness.
- The restriction of movements is both active (more pronounced) and passive (less pronounced).
- The sound of crepitus ("crunch", "squeak", as when walking in the snow) when trying to move or move a limb.
- The fracture area is hyperemic, sometimes it can be combined with the formation of hematomas.
Diagnostic research
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 damaged limb in several projections to determine a more accurate picture of the nature of the styloid process fracture of the radius.
Urgent events
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 in the absence of the first on hand. Since ice has a vasoconstrictive effect, it prevents the growth of edema, and in addition it also has a less pronounced analgesic effect.
Therapeutic measures
For 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 on the opposite side and squeeze the victim’s hand tightly. It is necessary to compress strongly enough so that the fragments occupy their normal physiological position. Otherwise, poor-quality reposition procedures can lead to impaired functioning of the limb, and in some cases entails the disability of the patient.
Separation of the styloid process of the radius
In contrast to the compression fracture described above , in this case, a complete separation of the bone element is observed.
This is most often observed when falling on an outstretched arm, in which the wrist deviates inward, and the styloid process is removed from the radius and comes off. Sometimes this occurs with a complete dislocation of the wrist joint.
The styloid processes of the radius and ulna are very fragile.
Clinical manifestations
Symptoms of such a fracture are as follows:
- A sharp pain that occurred in the first minutes after an injury when trying to move a damaged hand. Therefore, the patient takes the most favorable and sparing position for this hand.
- A creaking sound is heard due to the friction of the bone surfaces against each other.
- The phenomena of crepitus.
- Pronounced swelling, accompanied by the formation of hematomas.
Diagnostic measures
With the displacement of the styloid process of the radius, the following measures should be taken:
- History taking.
- Inspection by a traumatologist.
- X-ray examination in the direct and lateral projection of the wrist joint.
- If necessary, it is possible to conduct such additional research methods as, for example, computed tomography (CT) or ultrasound examination of soft tissues (ultrasound).
How to treat a fracture of the styloid process of the radial bone?
Treatment
The most important thing is to carry out a bone reduction with subsequent immobilization by means of a plaster cast, which is worn for at least one month. Then a repeated x-ray examination is carried out in order to make sure that the fragments grow together correctly. This is to ensure maximum mobility in the physiological places of the joints of the composite surfaces.
If necessary, surgery is performed using foreign fixation devices (pins, screws).
Drug therapy consists in the use of vitamin D and calcium-enriched preparations to minimize the period of adequate bone fusion in the rehabilitation period, since styloid of the styloid process of the radial bone may develop with improper treatment.
First aid
Since it is not always possible to deliver the victim to a medical institution in the first minutes, it is necessary to have an idea of first aid with the help of available means.
First of all, you need to immobilize (immobilize) the injured limb, fix it with some tissue, apply a splint, this is done 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, disinfecting solution (hydrogen peroxide or, for example, alcohol iodine solution) is suitable. The solution is applied to any torn piece of cloth or tissue, and the area is treated. This is done to disinfect the wound of the fracture and prevent infection of various types by pathogenic agents.
Since the patient is worried about a severe pain syndrome, it is necessary to give him painkillers groups of drugs, for example steroidal anti-inflammatory drugs (NSAIDs). The most effective are Diclofenac, Ketoprofen or Ibuprofen.
In addition to all of the above, one should not forget about the cold, which must be immediately put on the fracture site of the styloid process of the radius (photo below).
Rehabilitation measures
They include a set of measures aimed at speedy fusion of bone surfaces between themselves and a faster recovery.
There are physiotherapy procedures, the most effective of which are visits to ultraviolet radiation (UV), 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 and pulsed EP UHF in combination with magnetic stimulation of damaged nerve fibers are added.
After removal of the gypsum sponge, physical therapy classes with a visit to the massage course are shown. They stimulate the speedy restoration of lost limb functions by strengthening the neuromuscular system and restore transmission of electrical impulses from the damaged limb and vice versa.
Regarding nutrition, you also need to consider that you should eat more foods that are rich in calcium and vitamin D. These are primarily milk, cottage cheese, sour cream, seafood, hard cheeses, legumes, herbs, dried fruits (dried apricots, prunes), veal, liver as well as fish oil.
Disability recovery deadlines
They are determined individually depending on the general condition of the body and the presence of complications. But on average they are about a month and a half.
Possible complications
The following consequences may develop with improper treatment:
- By attaching an infection at any stage of care. Purulent-septic inflammation develops with a menacing transition to death.
- Damage to the neurovascular bundle, which can threaten the development of contractures (restrictions on movements in the joint).
- Improper bone fusion with the formation of a false joint and deformation of the limb as a whole.
- The development of osteomyelitis (purulent-septic lesion of both the bone marrow and the bone apparatus).
- Neurotrophic complications.
- A cosmetic defect in the form of the so-called “bulging” of the styloid process of the radius.
- Various options for deformations of the bone and articular apparatus.