Arthroscopic wafer procedure versus ulnar shortening osteotomy for ulnar impaction syndrome: a systematic review and meta-analysis

Abstract

Purpose This study aimed to systematically compare the efficacy and safety of arthroscopic wafer procedure (AWP) versus ulnar shortening osteotomy (USO) for ulnar impaction syndrome (UIS) treatment. Methods All the studies included in this meta-analysis compared the efficacy of AWP to USO for UIS and were acquired through a comprehensive search across multiple databases. The meta-analysis was performed by calculating the effect sizes with the Cochrane Collaboration’s RevMan 5.4 software. Results A total of 8 articles were included in this analysis, comprising 148 cases in the AWP group and 163 cases in the USO group. The pooled estimates indicated no significant differences in combined Darrow’s Criteria or Modified Mayo Wrist Score, Modified Mayo Wrist Score, DASH scores, grip strength, VAS score, and postoperative ulnar variation. On the other hand, the patients in the AWP group exhibited fewer complications (OR = 0.17, 95%CI 0.05–0.54, P = 0.003) and a lower reoperation rate (OR = 0.12, 95%CI 0.05–0.28, P < 0.00001) than those in the USO group. Conclusions The two surgical techniques were both effective in treating UIS but the AWP group showed fewer complications and a lower reoperation rate. Therefore, AWP may present a superior alternative for UIS treatment.

Clinical Outcomes and Failure Rate of Triangular Fibrocartilage Complex Foveal Repair Were Comparable between Arthroscopic and Open Techniques

“…As for the arthroscopy group, arthroscopic debridement of TFCC and wafer procedures (distal ulnar resection) were performed in eight patients, and three patients underwent ulnar shortening osteotomies, whereas for the open group, these procedures were performed on eight and four patients separately. Surgical indication of the wafer procedure was performed when ulnar variance was lower than 3 mm, whereas ulnar shortening osteotomy was performed when ulnar variance was greater than 3 mm [28,29].…”

Osteoarthritis of the wrist

“…Der Autor bevorzugt bei höhergradigen degenerativen Veränderungen und tendenziell älteren Patienten ein arthroskopisches Vorgehen, das eine schnellere Rekonvaleszenz und weniger Komplikationsmöglichkeit bietet ([ 50 ]; Abb. 8 ).…”