Clinical Outcomes of Single Intramedullary K-Wire Fixation with Figure-of-Eight Suture Augmentation for Ulnar Styloid Base and Distal Ulnar Metaphyseal Fractures

Background/Objectives: The optimal fixation method for ulnar styloid base fractures remains controversial. Conventional dual K-wire fixation may be technically challenging in certain fracture configurations, whereas hook plate fixation provides rigid fixation but requires additional implant placement and surgical exposure. The purpose of this study was to evaluate the clinical and radiographic outcomes of single intramedullary K-wire fixation combined with figure-of-eight suture augmentation for ulnar styloid base and distal ulnar metaphyseal fractures. Methods: We retrospectively reviewed 60 patients who underwent fixation of ulnar styloid base or distal ulnar metaphyseal fractures associated with distal radius fractures between 2021 and 2024. The construct consisted of a single intramedullary K-wire augmented with a figure-of-eight Ethibond suture. Radiographic union, functional outcomes, pain, range of motion, and complications were assessed at final follow-up. Results: The median follow-up was 14 months (range, 12–60). Radiographic union was achieved in 58 of 60 patients (96.7%) at a mean of 9.6 ± 1.9 weeks. The median QuickDASH score was 4.5 (range, 0–18.2), the Modified Mayo Wrist Score was 91.7 ± 8.1, and the visual analogue scale score for ulnar-sided wrist pain was 1.7 ± 1.0. Two patients (3.3%) developed radiographic nonunion, but neither required revision surgery. No fixation failure, loss of reduction, deep infection, or revision fixation occurred. Conclusions: Single intramedullary K-wire fixation with figure-of-eight suture augmentation was associated with a high rate of radiographic union and favorable functional outcomes in ulnar styloid base and distal ulnar metaphyseal fractures. These findings support the clinical feasibility of this fixation construct.