{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T03:16:34Z","timestamp":1787886994840,"version":"build-2784847793"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Freiburg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Surg Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ulnar styloid fractures (USF) are frequently underestimated and can contribute to clinically relevant wrist instability and impaired functional outcomes. Several osteosynthesis techniques are available for the treatment of unstable USF. This study aims to compare the biomechanical stability of fixation methods applicable to closed reduction \u2014 specifically K-wire and headless compression screw fixation \u2014 to support clinical decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This biomechanical in vitro study was conducted using 30 specimens of artificial ulnae. USF were simulated through a standardized osteotomy at the base. Three groups of ten specimens each were created to compare three methods of osteosynthesis: One 1.4\u00a0mm (mm) Kirschner-wire (K-wire) (Group 1KW), two 1.0\u00a0K-wires (Group 2KW) or one 2.0 cannulated headless screw (Group CHS). Each construct underwent 1,000 load cycles up to 50 newtons (N) followed by load-to-failure testing, which was defined as displacement\u2009\u2265\u20092\u00a0mm. Displacement [mm], stiffness [N\/mm] and load to failure [N] were recorded and compared among the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean fracture displacement after 1,000 cycles was 0.58\u00a0mm (SD 0.37) in the 1KW group, 0.23\u00a0mm (SD 0.09) in the 2KW group and 0.09\u00a0mm (SD 0.03) in the CHS group. Significant group differences could be shown between CHS and 1KW (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) as well as between CHS and 2KW (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017). The mean construct stiffness was 269.95 (SD 45.72) N\/mm in the 1KW group, 484.08 (SD 207.60) N\/mm in the 2KW group and 730.95 (SD 241.42) N\/mm in the CHS group. Significant group differences could be shown between CHS and 1KW (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). The mean load-to-failure was 136.82 (SD 68.86) N in the 1KW group, 181.60 (SD 28.09) N in the 2KW group and 204.17 (SD 63.10) N in the CHS group. Significant group differences could be shown between CHS and 1KW (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ulnar styloid refixation with a headless compression screw provides superior axial stability compared to single or double K-wire fixation. This should be considered in the treatment of unstable USF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13018-026-07188-2","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T02:03:51Z","timestamp":1787882631000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A biomechanical comparison of closed-reduction osteosynthesis techniques for fractures of the ulnar styloid"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1245-6144","authenticated-orcid":false,"given":"Jonas","family":"Eck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inska","family":"Onken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian P.","family":"Maier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kilian","family":"Reising","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikos","family":"Karvouniaris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Bayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagen","family":"Schmal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferdinand C.","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"7188_CR1","doi-asserted-by":"publisher","first-page":"e0279210","DOI":"10.1371\/journal.pone.0279210","volume":"18","author":"VA Singh","year":"2023","unstructured":"Singh VA, Jia TY, Santharalinggam RD, Gunasagaran J. Relationship of ulna styloid fracture to the distal radio-ulnar joint stability. A clinical, functional, and radiographic outcome study. PLoS ONE. 2023;18:e0279210. https:\/\/doi.org\/10.1371\/journal.pone.0279210.","journal-title":"PLoS ONE"},{"key":"7188_CR2","doi-asserted-by":"publisher","first-page":"110768","DOI":"10.1016\/j.injury.2023.04.055","volume":"54","author":"PS Velmurugesan","year":"2023","unstructured":"Velmurugesan PS, Nagashree V, Devendra A, Dheenadhayalan J, Rajasekaran S. Should ulnar styloid be fixed following fixation of a distal radius fracture? Injury. 2023;54:110768. https:\/\/doi.org\/10.1016\/j.injury.2023.04.055.","journal-title":"Injury"},{"key":"7188_CR3","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1186\/1471-2474-14-186","volume":"14","author":"Y Chen","year":"2013","unstructured":"Chen Y, Zheng X, Shi H, Wangyang Y, Yuan H, Xie X, 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. https:\/\/doi.org\/10.1186\/1471-2474-14-186.","journal-title":"BMC Musculoskelet Disord"},{"key":"7188_CR4","doi-asserted-by":"publisher","first-page":"3121","DOI":"10.1007\/s00402-024-05399-y","volume":"144","author":"KH Kang","year":"2024","unstructured":"Kang KH, Lee SK, An YS. Comparative analysis of tension band wiring and hook plate fixation in ulnar styloid fractures: a focus on fracture type. Arch Orthop Trauma Surg. 2024;144:3121\u20138. https:\/\/doi.org\/10.1007\/s00402-024-05399-y.","journal-title":"Arch Orthop Trauma Surg"},{"key":"7188_CR5","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1055\/s-0041-1726309","volume":"10","author":"M Maniglio","year":"2021","unstructured":"Maniglio M, Park I, Zumstein M, Kuenzler M, McGarry M, Lee T. The Critical Size of Ulnar Styloid Fragment for the DRUJ Stability. J Wrist Surg. 2021;10:385\u201391. https:\/\/doi.org\/10.1055\/s-0041-1726309.","journal-title":"J Wrist Surg"},{"key":"7188_CR6","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1055\/s-0040-1719041","volume":"10","author":"T Nakamura","year":"2020","unstructured":"Nakamura T, Moy O, Peimer C. Relationship between Fracture of the Ulnar Styloid Process and DRUJ Instability: A Biomechanical Study. J Wrist Surg. 2020;10:111\u20135. https:\/\/doi.org\/10.1055\/s-0040-1719041.","journal-title":"J Wrist Surg"},{"key":"7188_CR7","doi-asserted-by":"publisher","first-page":"2835","DOI":"10.1016\/j.injury.2021.06.026","volume":"52","author":"M Maniglio","year":"2021","unstructured":"Maniglio M, Fraipont W, Flueckiger R, Zumstein MA, McGarry MH, Lee TQ. What\u2019s the best surgical repair technique of an ulnar styloid fracture? A biomechanical comparison of different techniques. Injury. 2021;52:2835\u201340. https:\/\/doi.org\/10.1016\/j.injury.2021.06.026.","journal-title":"Injury"},{"key":"7188_CR8","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1186\/s13018-025-06346-2","volume":"20","author":"JP Maier","year":"2025","unstructured":"Maier JP, Eck J, Erdle B, M\u00fchlenfeld N, Seidenstuecker M, Reising K, et al. Biomechanical analysis of biodegradable magnesium, zinc, and polylactide pins for fixation of radial head fractures. J Orthop Surg Res. 2025;20:870. https:\/\/doi.org\/10.1186\/s13018-025-06346-2.","journal-title":"J Orthop Surg Res"},{"key":"7188_CR9","first-page":"34","volume":"45","author":"O Ayalon","year":"2016","unstructured":"Ayalon O, Marcano A, Paksima N, Egol K. Concomitant Ulnar Styloid Fracture and Distal Radius Fracture Portend Poorer Outcome. Am J Orthop (Belle Mead NJ). 2016;45:34\u20137.","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"7188_CR10","doi-asserted-by":"publisher","first-page":"2843","DOI":"10.1007\/s00068-024-02660-2","volume":"50","author":"LX van Rossenberg","year":"2024","unstructured":"van Rossenberg LX, Beeres FJP, van Heijl M, Hug U, Groenwold RHH, Houwert RM, et al. Operative versus non-operative treatment of ulnar styloid process base fractures: a systematic review and meta-analysis. Eur J Trauma Emerg Surg. 2024;50:2843\u201354. https:\/\/doi.org\/10.1007\/s00068-024-02660-2.","journal-title":"Eur J Trauma Emerg Surg"},{"key":"7188_CR11","doi-asserted-by":"publisher","DOI":"10.18621\/eurj.1663265","author":"E Kaya","year":"2025","unstructured":"Kaya E, Akdemir NA, Ge\u00e7er A, Konuko\u011flu L. Risk factors for nonunion of ulnar styloid fractures associated with distal radius fractures. Eur Res J. 2025. https:\/\/doi.org\/10.18621\/eurj.1663265. 1\u20136.","journal-title":"Eur Res J"},{"key":"7188_CR12","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1177\/1753193419834858","volume":"44","author":"AN Cheema","year":"2019","unstructured":"Cheema AN, Dardas AZ, Hast MW, Gray BL. The effects of incremental ulnar styloid osteotomies on distal radioulnar joint stability: a biomechanical cadaveric study. J Hand Surg (Eur Vol). 2019;44:510\u20136. https:\/\/doi.org\/10.1177\/1753193419834858.","journal-title":"J Hand Surg (Eur Vol)"},{"key":"7188_CR13","doi-asserted-by":"publisher","first-page":"142","DOI":"10.5704\/moj.2303.017","volume":"17","author":"W KC","year":"2023","unstructured":"KC W, QJJ MWFW, MK Z, TS W, SBJ H. Concomitant Ulnar Styloid Fractures in Distal Radius Osteosynthesis Does Not Impact Radiographic Outcomes, Ulnar Sided Symptoms and Patient Outcomes. Malays Orthop J. 2023;17:142\u20138. https:\/\/doi.org\/10.5704\/moj.2303.017.","journal-title":"Malays Orthop J"},{"key":"7188_CR14","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1186\/s13018-020-01795-3","volume":"15","author":"AC-Y Chen","year":"2020","unstructured":"Chen AC-Y, Lin Y-H, Weng C-J, Cheng C-Y. Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire. J Orthop Surg Res. 2020;15:273. https:\/\/doi.org\/10.1186\/s13018-020-01795-3.","journal-title":"J Orthop Surg Res"}],"container-title":["Journal of Orthopaedic Surgery and Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13018-026-07188-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-026-07188-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-026-07188-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T02:17:58Z","timestamp":1787883478000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13018-026-07188-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["7188"],"URL":"https:\/\/doi.org\/10.1186\/s13018-026-07188-2","relation":{},"ISSN":["1749-799X"],"issn-type":[{"value":"1749-799X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]},"assertion":[{"value":"26 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"517"}}