11 Open Reduction and Internal Fixation of an Ulnar Styloid Fracture

• a linear incision is made along ulnar border of the hand and wrist. The incision begins 1 cm distal to the ulnar styloid and extends to the subcutaneous border of the ulna, palmar to the extensor carpi ulnaris (ECU) tendon sheath (Fig. 11-1).

Figure 11-1

Pitfall

Avoid the dorsal cutaneous branch of ulnar nerve that passes obliquely between the ulnar styloid and pisiform.

• Expose with subperiosteal dissection the ulnar aspect of the styloid and the ulnar head. Do not open the ECU subsheath (Fig. 11-2).
  
• Reduce the styloid and insert two parallel 0.35 in. pins through the tip and into the ulnar head.
  
• Advance the pins so that they barely perforate the medial metaphysis of the ulnar neck.

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