A Comparison of Ulnar Shortening Osteotomy Alone Versus Combined Arthroscopic Triangular Fibrocartilage Complex Debridement and Ulnar Shortening Osteotomy for Ulnar Impaction Syndrome

Abstract

BackgroundThis study compared the results of patients treated for ulnar impaction syndrome using an ulnar shortening osteotomy (USO) alone with those treated with combined arthroscopic debridement and USO.MethodsThe results of 27 wrists were reviewed retrospectively. They were divided into three groups: group A (USO alone, 10 cases), group B (combined arthroscopic debridement and USO, 9 cases), and group C (arthroscopic triangular fibrocartilage complex [TFCC] debridement alone, 8 cases). The wrist function was evaluated using the modified Mayo wrist score, disabilities of the arm, shoulder and hand (DASH) score and Chun and Palmer grading system.ResultsThe modified Mayo wrist score in groups A, B, and C was 74.5 ± 8.9, 73.9 ± 11.6, and 61.3 ± 10.2, respectively (p < 0.05). The DASH score in groups A, B, and C was 15.6 ± 11.8, 19.3 ± 11.9, and 33.2 ± 8.5, respectively (p < 0.05). The average Chun and Palmer grading score in groups A and B was 85.7 ± 8.9 and 84.7 ± 6.7, respectively. The difference in the Mayo wrist score, DASH score and Chun and Palmer grading score between group A and B was not significant (p > 0.05).ConclusionsBoth USO alone and combined arthroscopic TFCC debridement with USO improved the wrist function and reduced the level of pain in the patients treated for ulnar impaction syndrome. USO alone may be the preferred method of treatment in patients if the torn flap of TFCC is not unstable.

How Does Ulnar Shortening Osteotomy Influence Morphologic Changes in the Triangular Fibrocartilage Complex?

“…Some authors reported good clinical results after ulnar shortening osteotomy for TFCC tears with a positive ulnar variance [6,14,17]. We found no relationships between the Mayo Wrist Score and TFC thickness or the TFC angle on MR images; however, all our patients had excellent or good outcomes based on the Mayo Wrist Score.…”

Ulnar-sided Wrist Pain: Evaluation and Treatment of Triangular Fibrocartilage Complex Tears, Ulnocarpal Impaction Syndrome, and Lunotriquetral Ligament Tears

“…Arthroscopy at the time of ulnar shortening has been shown to have no additional benefit over shortening alone. 49 Results of ulnar shortening osteotomy are generally good. Baek et al 50 Poor outcomes were associated with degenerative changes at the DRUJ, long duration of symptoms, and workers' compensation claims.…”

Who introduced the "quadrangular-construct" modification of the Sauvé Kapandji procedure first? Case presentation and brief overview of literature with regard to general, specific and practicable aspects to primary trauma-related surgical treatment including possible salvage options at the distal radioulnar joint

“…UPV shorter than 2 mm), and also noted that wrist arthroscopy is associated with a complication rate of 6 % respectively [49,50]. Likewise, recent evidence suggests that ulnar shortening osteotomy (USO) accompanied with wrist arthroscopy does not always lead to satisfactory outcomes in patients with long duration of symptoms, and it does not confer any additional benefit over USO alone as well [40,[51][52][53]. Furthermore, evident UPV is considered to be contraindication for arthroscopy of the DRUJ [54].…”

“…should be positioned dorsoulnar ( Figure 5) that safely prevents soft tissue complications and painful impingement with the IOM potentially leading to loss of forearm rotation [51][52][53][69][70][71][72][73]. However, despite of correct performing USO accompanied with a correctly positioned plate, patient's disability is reported to be up to 19% after surgery, and so the postoperative course remains not always predictable [53,74].…”