Radial styloidectomy: a biomechanical study on stability of the wrist joint

J Hand Surg Am. 2001 Jan;26(1):85-93. doi: 10.1053/jhsu.2001.20963.

Abstract

We investigated the influence of radial styloidectomy on carpal alignment and examined translation of the wrist after sequentially increased styloidectomy of 8 cadaver wrists. The radial aspect of the scaphoid fossa of the distal radius was cut obliquely at 3, 6, and 10 mm from the radial styloid guided by real-time fluoroscopy. Radiographic analysis of the changes of carpal alignment was performed with the wrist in neutral position. Force-displacement curves from the neutral to the radioulnar and palmar-dorsal directions were obtained using a multi-axis testing machine. Results demonstrated no significant malalignment of the carpal bones after radial styloidectomy. Significantly increased radial translation (>40% reduction in stiffness), however, was observed due to the loss of radial articular contact after 6- and 10-mm radial styloidectomies. Significant ulnar and palmar carpal displacement also was noted after 6- and 10-mm radial styloidectomies, with 6 specimens demonstrating moderate ulnar and palmar translation and 2 demonstrating notable increased palmar and ulnar translations. We conclude that there is a definite risk of increased carpal instability with radial styloidectomy procedures. A styloidectomy of no more than 3 to 4 mm is recommended.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomechanical Phenomena
  • Carpal Bones / diagnostic imaging
  • Carpal Bones / physiopathology*
  • Female
  • Humans
  • Joint Instability / diagnostic imaging
  • Joint Instability / physiopathology*
  • Male
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / physiopathology*
  • Radiography
  • Radius / diagnostic imaging
  • Radius / physiopathology
  • Radius / surgery*
  • Range of Motion, Articular / physiology
  • Wrist Joint / diagnostic imaging
  • Wrist Joint / physiopathology
  • Wrist Joint / surgery*