Freehand technique with the predrilled hole method for ulnar-shortening osteotomy

Aim This study aims to evaluate the long-term complications, results, and patient satisfaction rates of a dorsally approached ulnar shortening osteotomy for ulnar impaction syndrome. Methods A retrospective chart review of 20 patients was performed. Primary outcomes of interest were subjective, measured using the Patient-Rated Wrist Evaluation (PRWE) score, Disability of the Arm, Shoulder, and Hand (DASH) score, and the third questionnaire about patient satisfaction, composed by the authors. Secondary outcomes included hardware removal due to irritation and other complications. Results Mean postoperative functional score of PRWE was 28 (standard deviation [SD], 30) and DASH 20 (SD, 26), respectively. Fifteen patients were satisfied with the operation. Removal of hardware was noted in six patients. In one patient plate breakage occurred. Conclusion Similar postoperative functional scores and complications were seen in patients undergoing an ulnar shortening osteotomy with a dorsally placed plate for ulnar impaction syndrome, compared with other plate placement localizations. The incidence of plate removal is also comparable to previously described results. As the dorsally placed plate and freehand technique, are relatively easy, we feel that it has a place in the treatment of ulnar impaction syndrome. Level of Evidence Level IV, retrospective cohort study.

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“…Hardware removal rates range from 6 to 25%. 6,15,23 In our study, the occurrence of hardware removal was 30%.…”

Section: Discussionmentioning

confidence: 46%

A Dorsal Approach for Ulnar Shortening Osteotomy

2017

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“…Traditionally, the osteotomy was done using free-hand technique. Technical notes have been published to improve the reproducibility of free-hand ulnar shortening osteotomy [9]. To optimize usability and precision, several commercially available USO systems have been developed [7,8].…”

Section: Discussionmentioning

confidence: 99%

“…The second surgeon was a senior resident with a general understanding of the steps for free-hand ulnar shortening. The free-hand technique was illustrated in our previous publication [9]. Prior to testing, neither subject had experience using the ulnar shortening system described in this study.…”

Section: Testing the Ulnar Shortening Systemmentioning

confidence: 99%

“…As a result, without sufficient experience, many surgeons tend to be conservative in bringing up USO as a treatment option for those who may benefit from the surgery. To flatten the learning curve of performing ulnar shortening osteotomy, based on the published "predrilled free-hand technique for USO", leveraging metal additive manufacturing technology, our team developed an ulnar shortening osteotomy system for commercially available 3.5 mm dynamic compression plate to facilitate accurate osteotomy and implant fixation [9]. Additive manufacturing technology enabled hospital in-house surgical system design under small budget.…”

Section: Introductionmentioning

confidence: 99%

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Enabling the design of surgical instruments for under-resourced patients through metal additive manufacturing: ulnar shortening osteotomy as an example

Chen,

Yin,

Huang

et al. 2024

3D Print Med

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Background Ulnar shortening osteotomy (USO) has demonstrated good outcomes for patients with ulnar impaction syndrome. To minimize complications such as non-union, precise osteotomy and firm fixation are warranted. Despite various ulnar shortening systems have been developed, current technology does not meet all needs. A considerable portion of patients could not afford those designated USO systems. To tackle this challenge, our team reported successful results in standardized free-hand predrilled USO technique. However, it is still technical demanding and requires sufficient experience and confidence to excel. Therefore, our team designed an ulnar shortening system based on our free-hand technique principle, using metal additive manufacturing technology. The goal of this study is to describe the development process and report the performance of the system. Methods Utilizing metal additive manufacturing technology, our team developed an ulnar shortening system that requires minimal exposure, facilitates precise cutting, and allows for the easy placement of a 3.5 mm dynamic compression plate, available to patients at zero out-of-pocket cost. For performance testing, two surgeons with different levels of experience in ulnar shortening procedures were included: one fellow-trained hand and wrist surgeon and one senior resident. They performed ulnar shortening osteotomy (USO) using both the free-hand technique and the USO system-assisted technique on ulna sawbones, repeating each method three times. The recorded parameters included time-to-complete-osteotomy, total procedure time, chip diameter, shortening length, maximum residual gap, and deviation angle. Results For the hand and wrist fellow, with the USO system, the time-to-complete osteotomy was significantly reduced. (468.7 ± 63.6 to 260.0 ± 5 s, p < 0.05). Despite the preop goal was shortening 3 mm, the average shortening length was significantly larger in the free-hand group (5 ± 0.1; 3.2 ± 0.2 mm, p < 0.05). Both maximum residual gap and deviation angle reported no statistical difference between the two techniques for the hand surgeon. As for the senior resident, the maximum residual gap was significantly reduced, using the USO system (2.9 ± 0.8; 0.4 ± 0.4 mm, p = 0.02). Between two surgeons, significant larger maximum residual gap and deviation angle were noted on the senior resident doctor, in the free-hand technique group, but not in the USO system group. Conclusion The developed USO system may serve as a valuable tool, aiding in reliable and precise cutting as well as fixation for patients undergoing ulnar shortening osteotomy with a 3.5 mm dynamic compression plate, even for less experienced surgeons. The entire process, from concept generation and sketching to creating the CAD file and final production, serves as a translatable reference for other surgical scenarios.

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“…Most of Nb and Ta ore deposits were hosted in pegmatites, alkali intrusive rocks, carbonatites, alluvial sandstones and Li-F-rich granites [2,3] . The pegmatites and Li-F-rich granites types of ore deposits are dominated by Ta and the other ore deposits are dominated by Nb.…”

Section: Ore Geologymentioning

confidence: 99%

Analysis on the Metallogenic Conditions and Perspective of Nb-Ta Mineral in ZhaoJinggou, Inner Mongolia

Hua²,

Wu³

et al. 2014

AMR

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ZhaoJinggou Nb-Ta deposit was discovered in 1967.After a series of exploration, a summary report of preliminary exploration of ZhaoJinggou Nb-Ta deposit was submitted. The detail exploration was carried out in this mineral aera in 2010.The deposit was sited in the middle part of the northern margin of north China platform, YinShan lifted block and north wing of Daqingshan anticlinorium. A series of metamorphose rocks of Proterozoic to Neoproterozoic were widely distributed in this area. Nb-Ta veins intruded into the structural fissure of dark grey pebbled metamorphic sandstone of Middle Carboniferous Shuanmazhuang Formation. Through verification of deep drilling, it exsited a larger decalcified feldspathized granodiorites and albite granites, which had a relationship with the formation of these veins. The intensity of albitization determined the grade of Nb-Ta minerals.And albitization caused the richment of other rare elements, which had a comprehensive utilization value. Based on the detailed exploration, the Zhaojinggou deposit should have a good mineralize perspective, which may exist the large alkaline albite lithium mica granite Nb-Ta deposits in deep or outer-ring of mining area.

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Freehand technique with the predrilled hole method for ulnar-shortening osteotomy

Abstract: Our technique is easy and quick to use and can minimize soft-tissue manipulation. The union rate is high and complications are few.

Cited by 4 publications

References 23 publications

A Dorsal Approach for Ulnar Shortening Osteotomy

A Dorsal Approach for Ulnar Shortening Osteotomy

Enabling the design of surgical instruments for under-resourced patients through metal additive manufacturing: ulnar shortening osteotomy as an example

Analysis on the Metallogenic Conditions and Perspective of Nb-Ta Mineral in ZhaoJinggou, Inner Mongolia

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