Ulnar styloid fractures and early clinical outcomes in older patients with conservatively treated distal radius fractures: a TriNetX database-based retrospective cohort study

Abstract While ulnar styloid fractures (USF) are common concomitants of distal radius fractures (DRF), their impact on recovery in conservatively treated geriatric patients remains controversial. This study evaluated whether concomitant USF was associated with early healthcare-recorded outcomes. Using the TriNetX US Collaborative Network database (2005–2023), we identified patients ≥ 65 years with conservatively managed DRF. A total of 18,032 patients with distal radius fracture and concomitant ulnar styloid fracture (Cohort A) and 149,723 patients with isolated distal radius fracture (Cohort B) were included. The mean age at fracture was 72.2 year-old (Cohort A) and 72.1 year-old (Cohort B). USF was associated with higher frequencies of recorded wrist pain diagnoses within 3 months (RR 1.54, 95% CI 1.45–1.64; p < 0.001), 3–12 months (RR 1.50, 95% CI 1.30–1.73; p < 0.001) and newly recoded ICD-coded mental health diagnoses within 3 months (RR 1.29, 95% CI 1.12–1.52; p < 0.001). There was no significant difference in wrist pain, mental health disorders, wrist stiffness, analgesic use and wrist osteoarthritis diagnoses after 3 years of follow-up. These findings suggest that USF may serve as a clinical marker of early healthcare-recorded burden, but may partly reflect unmeasured injury severity, healthcare utilization.