TFCC injury can be divided into disc tear and peripheral tear. TFCC injuries are the most common associated intraarticular injuries with DRF, and may cause USWP. Although malunion is a three-dimensional deformity, extraarticular malunited DRF are often categorized on radiographs as palmarly angulated, dorsally angulated, loss of radial inclination, and/or radial shortening. USWP after DRF has mainly been attributed to malunion, creating an imbalance distally, which might lead to ulno-carpal abutment, incongruency, and osteoarthrosis of the distal radioulnar joint (DRUJ). As the natural course is mostly benign and self-limiting, persistent USWP is much less common and necessities a careful diagnostic work-up before surgical treatment. Acute injury of the TFCC and ulnar styloid fractures are common, and treatment remains controversial as routine repair is not indicated. USWP is common after DRF and can improve for a year or more, so patience and exhausting conservative trial outs are generally warranted. What are the main causes of persistent USWP after healed DRF and how is it best managed? It is considered the benchmark for the diagnosis and management of TFCC injuries and other pathologies including carpal ligament injuries. Wrist arthroscopy plays an increasingly important role in the diagnosis and management of persistent USWP. A comprehensive examination of the wrist such as inspection, palpation, provocative maneuvers, radiography, computed tomography (CT), magnetic resonance imaging (MRI), and wrist arthroscopy are required. The causes of pain are often difficult to diagnose and resolve. However, USWP after DRF healed is often encountered, though only some of these patients have persistent moderate to severe pain that persists even a few years after, limiting proper function of the hand. The development of palmar locking plate fixation for surgical treatment for DRF provides rigid fixation, maintains accurate reduction acquired when the surgery was carried out, results successful outcome. DRF is the most common fracture in the upper extremity, and is frequently associated with injury of the ulnar wrist structures such as the ulnar styloid, TFCC, lunotriquetral (LT) ligament, etc. Pain may derive from injured forearm and carpal bones, TFCC, ligament tears, tendinitis, vascular pathology, osteoarthritis and systemic arthritis, and ulnar nerve compression. The history and physical examination findings for a wide range of pathologies often overlap. USWP is a common complaint that contains a diagnostic challenge for hand surgeons because of the small and complex anatomic structures involved. Ulnar styloid nonunion was recognized on radiograph and MRI.
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