Arthroscopic Wafer Procedure Versus Ulnar Shortening Osteotomy as a Surgical Treatment for Idiopathic Ulnar Impaction Syndrome

Oh, Won-Taek; Kang, Ho-Jung; Chun, Yong-Min; Koh, Il-Hyun; An, Haemosu; Choi, Youn Jin

doi:10.1016/j.arthro.2017.08.306

Cited by 28 publications

(35 citation statements)

References 32 publications

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“…informaron pacientes que se sometieron a resección de la oblea (procedimiento de oblea de artroscopia) evaluados con mejor fuerza de agarre y puntajes DASH a los 3 meses después de la cirugía pero, a los 2 años de seguimiento, los resultados fueron similares en el grupo tratado con OAC. 17 Las desventajas del tratamiento de resección de la oblea tradicional de SIC es la incapacidad y la precisión del acortamiento longitudinal del cúbito y la eliminación de la superficie del cartílago de la cabeza del cúbito. Kim y Song concluyeron que el aumento artroscópico combinado con OAC mejoró los resultados clínicos y funcionales en los pacientes tratados por síndrome de impactación cubital.…”

Section: Discussionunclassified

Ulna Shortening Osteotomy Combined Arthroscopy augmentation for Ulnar Impaction Syndrome: A prospective Analysis

Aita

Cardoso

Silva

et al. 2023

Revista Iberoamericana de Cirugía de la Mano

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Resumén Objetivo Este estudio tuvo como objetivo mostrar los resultados clínicos y reportados por los pacientes obtenidos con osteotomía de acortamiento cubital (OAC) combinada con artroscopia en síndromes de impactación cubital (SIC) en pacientes activos. Materiales y Métodos En este estudio clínico prospectivo, se asignó a 13 pacientes a someterse a osteotomía de acortamiento cubital (OAC) definitiva combinada con artroscopia para el síndrome de impactación cubital (SIC). La fuerza de agarre, el rango de movimiento (ROM), la medida de resultado de discapacidades del brazo, el hombro y la mano (QuickDASH), la puntuación de la escala analógica visual (EVA) para el dolor y las características radiográficas se evaluaron a los 6 y 12 meses. Descripción de la técnica Se utiliza una incisión longitudinal para exponer el cúbito. Se preperfora un sistema de acortamiento de cúbito específico para realizar osteotomías separadas por la longitud de acortamiento deseada. Posteriormente, realización de artroscopia de muñeca para realizar técnica de microfractura en el semilunar, piramidal, cabeza de cúbito con punción específica (Chondro Pick,20° by Arthrex®, Na-ples,USA). Se reparó complejo del fibrocartílago triangular (CFCT) y lunopiramidal (LP). Resultados EVA 2.77. La media de QuickDASH fue de 4. Dos pacientes presentaron retraso en la consolidación y se resolvieron con tratamiento no quirúrgico. Conclusión Se encontró que la OAC con artroscopia es un método de tratamiento definitivo, seguro y confiable para SIC en pacientes activos. Los resultados de la EVA y la fuerza de prensión predicen la restauración de la capacidad de los pacientes activos para realizar las actividades de la vida diaria (AVD) de forma independientes.

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Section: Discussionunclassified

Ulna Shortening Osteotomy Combined Arthroscopy augmentation for Ulnar Impaction Syndrome: A prospective Analysis

Aita

Cardoso

Silva

et al. 2023

Revista Iberoamericana de Cirugía de la Mano

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“… 27 In the current study, the average age was 65 years, and 14 of 15 patients (93.3%) had positive UV. Because Kienböck’s disease in elderly patients tends with positive UV and smaller UTD, the surgeons should be aware of the risk of postoperative ulno-carpal impaction syndrome and should explain the possibility of additional arthroscopic surgery, such as wafer procedure 28 in the application of arthroscopic lunate excision.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Lunate Excision Provides Excellent Outcomes for Low-Demand Patients with Advanced Kienböck’s Disease

Shimizu

Omokawa

Kawamura

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: To examine the clinical outcomes of arthroscopic lunate excisions for advanced Kienböck's disease. Methods: Fifteen patients (six men and nine women; mean age: 65 years; range: 48-83 years) with advanced Kienböck's disease, who underwent arthroscopic lunate resection between April 2008 and March 2016, were reviewed clinically and radiographically after a follow-up of >2 years (mean: 29 months; range: 24-60 months). Clinical parameters, such as wrist range of motion, grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and patient-rated wrist evaluation (PRWE) score were evaluated. Radiographic parameters included radioscaphoid angle, scaphocapitate angle, carpal height ratio, ulnar-triquetrum distance, and the scaphoid-triquetrum distance. Wilcoxon's signed-rank test was used to compare measurement results. Results: During the final follow-up, patients exhibited significant improvements, such as 42.9 in wrist range of motion (P ¼ .009), 24.5% of the contralateral side in grip strength (P ¼ .001), 26.2 points in DASH score (P ¼ .002), and 37.8 points in PRWE score (P < .001), compared with the preoperative values. The radioscaphoid and scaphocapitate angles significantly increased by 4.8 (P ¼ .0027) and 3.7 (P ¼ .0012), respectively. The carpal height ratio, ulnar-triquetrum distance, and scaphoid-triquetrum distance significantly decreased by 0.05 (P < .001), 2.6 mm (P < .001), and 1.3 mm (P ¼ .0012), respectively. Conclusions: Our results suggest that arthroscopic lunate excisions provided excellent postoperative pain relief and functional recovery within 2 years of follow-up. Changes in carpal alignment and stress concentration on the radial side of the carpal bones could occur in the long term; however, arthroscopic lunate excision can be a good surgical option for treating low-demand patients with advanced Kienböck's disease. Level of Evidence: Level IV, therapeutic case series

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“…The management of many other relatively common subtypes of wrist osteoarthritis is similarly hampered by a lack of high-quality evidence. This is demonstrated in the case of degenerative ulnocarpal disorders, which may also referred to as ulnar abutment, or ulnar impaction syndrome where the available evidence base consists exclusively of low-quality and highly biased retrospective case series, which invariably demonstrate no meaningful difference in outcome between different surgical interventions 19– 22 . Not only are there no prospective studies, but to our knowledge no study has compared non-operative with operative intervention.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic interventions for osteoarthritis of the wrist: a systematic review and meta-analysis

et al. 2018

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Background: In order to evaluate the effectiveness of interventions for osteoarthritis of the wrist in adults we performed a systematic review and meta-analysis. Methods: The MEDLINE and EMBASE via OVID, CINAHL and SPORTDiscus via EBSCO databases were searched from inception to 25 th April 2018.All randomised controlled clinical trials (RCTs) and any prospective studies of adults with wrist osteoarthritis investigating any intervention with a comparator were included. Data were extracted and checked for accuracy and completeness by pairs of reviewers. Primary outcomes were pain and function. Comparative treatment effects were analysed by random effects at all time points. Results: Three RCTs were identified for inclusion after screening and all had a high risk of bias. Two compared proximal row carpectomy (PRC) with four corner fusion (4CF) for post-traumatic osteoarthritis, while the other compared leather with commercial wrist splints in patients with chronic wrist pain, of which a small group had wrist osteoarthritis. Conclusion: There is no prospective study comparing operative to non-operative treatment for wrist osteoarthritis, while there is a paucity of prospective studies assessing the effectiveness of both non-operative and operative interventions. Further research is necessary in order to better define which patients benefit from which specific interventions. Registration: The review protocol was registered with PROSPERO under the registration number CRD42018094799.

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Arthroscopic Wafer Procedure Versus Ulnar Shortening Osteotomy as a Surgical Treatment for Idiopathic Ulnar Impaction Syndrome

Cited by 28 publications

References 32 publications

Ulna Shortening Osteotomy Combined Arthroscopy augmentation for Ulnar Impaction Syndrome: A prospective Analysis

Ulna Shortening Osteotomy Combined Arthroscopy augmentation for Ulnar Impaction Syndrome: A prospective Analysis

Arthroscopic Lunate Excision Provides Excellent Outcomes for Low-Demand Patients with Advanced Kienböck’s Disease

Therapeutic interventions for osteoarthritis of the wrist: a systematic review and meta-analysis

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