Mar shortening osteotomy in posttraumatic ulnar impaction syndrome

Fricker, R.; Pfeiffer, Karl M.; H, Troeger

doi:10.1007/bf00434545

Cited by 47 publications

(39 citation statements)

References 13 publications

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“…Fricker et al followed 28 patients with post-traumatic ulnar impaction for an average of 20 months and found that 79% returned to their preoperative level of occupation [6]. Constantine et al found that 82% (9 of 11) patients returned to previous level of employment [5].…”

Section: Discussionmentioning

confidence: 99%

“…Early outcomes following ulna shortening osteotomy for the treatment of ulnar impaction syndrome have demonstrated good pain relief, satisfactory objective outcomes (motion, strength, and healing), and patient satisfaction [1,4,6,12,16]. The most commonly reported complications of ulnar shortening osteotomy are plate irritation (8-56%) and ulnar nonunion (approximately 5%) [2,15,18].…”

Section: Introductionmentioning

confidence: 99%

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Mid-Term Results following Ulna Shortening Osteotomy

Fufa

Carlson

Calfee

et al. 2014

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Successful short-term results of diaphyseal ulna shortening osteotomy are documented in both idiopathic and post-traumatic ulnar impaction. Questions/Purposes: The purpose of this study was to evaluate the mid-term outcomes of ulnar shortening osteotomy with respect to radiographic assessment of corrected alignment and healing as well as patient satisfaction, pain, and function assessed using the Disability of the Arm, Shoulder, and Hand (DASH) score. Patients and Methods: This retrospective case series included follow-up of 33 patients with ulnar impaction syndrome following ulna shortening osteotomy at a minimum of 5 years. Patient-rated outcomes included satisfaction, pain assessment, and DASH score. Pre-and postoperative radiographs were reviewed to quantify ulnar variance and osteotomy union rates. Subsequent operations were also recorded. Results: Average followup was 10 years (range, 5-20 years). Eighty-eight percent of patients reported they were either satisfied or very satisfied with the procedure and 91% reported they would have the same procedure again. Average pain rating was 2 out of 10 at final follow-up. The mean DASH score was 11 (range, 0-39). Removal of hardware was performed in 10 patients (30%). The overall rate of reoperation was 45%. Conclusions: Ulna shortening osteotomy yields reliable midterm satisfaction and pain relief in patients with idiopathic and post-traumatic ulnar impaction syndrome. Reoperation is frequent. Consistent with results of short-term follow-up, plate irritation requiring removal remains the most common cause for reoperation over time.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mid-Term Results following Ulna Shortening Osteotomy

Fufa

Carlson

Calfee

et al. 2014

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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“…35 Other advantages of ulnar shortening osteotomy are the maintenance of the cartilage surface at the distal ulna and the simplicity of the procedure without bone grafting. 20,[36][37][38] The disadvantages of ulnar shortening are nonunion/delayed union and hardware irritation. 6,10,15,[17][18][19] However, rates of complication can be low if the procedure is properly performed, 5,38 and many papers have actually reported low complication rates.…”

Section: Discussionmentioning

confidence: 99%

“…20,30,[37][38][39] Combining the results using standard technique and equipment, 79 of 90 patients (88%) achieved good or excellent results regarding pain relief and recovery of function, with only one nonunion (1%). 5,9,14,18 Poor outcomes were associated with degenerative changes at the DRUJ, long duration of symptoms, smoking, and workers' compensation claims.…”

Section: Discussionmentioning

confidence: 99%

Ulnar Shortening Osteotomy for Ulnar-Sided Wrist Pain

et al. 2014

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The ulnar side of the wrist has been referred to as the "black box" of the wrist, and pathologies of this region have been compared with those of low back pain, 1,2 given the complex anatomy, myriad differential diagnosis, and varied treatment outcomes. Ulnar-sided wrist pain and arise from an acute traumatic injury or a chronic degenerative condition. Common causes of ulnar-sided wrist pain include isolated injuries to the triangular fibrocartilage complex (TFCC) or lunotriquetral ligament as well as ulnar impaction syndrome, which consists of a combination of these 2 conditions along with an Keywords ► ulnar shortening osteotomy ► ulnar-sided wrist pain ► TFCC ► DRUJ ► arthroscopy AbstractBackground The purpose of ulnar shortening osteotomy is literally to shorten the ulna. It can tighten the triangular fibrocartilage complex (TFCC), ulnocarpal ligaments, and interosseous membrane. Nowadays, this method is used to treat ulnar-sided wrist pain, for which we have also started to use a treatment algorithm. The purpose of this study was to review the long-term and clinical results based on our algorithm. Materials and Methods We retrospectively reviewed 30 patients with ulnocarpal impaction syndrome after a minimum follow-up of 5 years (Group A) and then retrospectively evaluated 66 patients with recalcitrant ulnar wrist pain treated based on our algorithm (Group B). Description of Technique Ulnocarpal abutment was confirmed arthroscopically. The distal ulna was approached through a longitudinal incision between the extensor carpi ulnaris and flexor carpi ulnaris. We performed a transverse resection of the ulna fixed with a small locking compression plate. The contralateral side served as the reference for the length of shortening (mean, 2.4 mm; range, 1-5 mm). Disappearance of ulnar abutment was then confirmed again arthroscopically. Results (Group A) Most patients showed good long-term clinical results. About half of the patients showed a bony spur at the distal radioulnar joint (DRUJ), but the clinical results did not significantly correlate with presence of bony spurs. Radiological parameters wre not related to the presence of bony spurs. (Group B) Twenty-four of the 66 patients investigated prospectively underwent an ulnar shortening osteotomy, with all showing good clinical results at 18 months postoperatively. Conclusions Ulnar shortening osteotomy can change the load of the ulnar side of the wrist and appears useful for ulnar-sided wrist pain in the presence of ulnar impaction. Level of evidence IV

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“…A previous study suggests, although the wafer resection is easier to perform than ulnar shortening, removing the articular cartilage surface of the distal ulna may have consequences [16]. Fricker et al [8] reported 89% of patients were satisfied at 20 months when questioned. In this instance, a high rate of patient satisfaction was combined with rather poor Gartland-Werley wrist scores.…”

Section: Discussionmentioning

confidence: 99%

Cartilage-retaining Wafer Resection Osteotomy of the Distal Ulna

Barry

Macksoud

2008

Clinical Orthopaedics &Amp; Related Research

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Ulnar-sided wrist pain resulting from ulnar impaction is common. We describe a new cartilageretaining wafer resection osteotomy designed to keep the cartilage intact and decompress the ulnocarpal articulation without requiring internal fixation. We retrospectively reviewed seven patients with ulnar impaction who had the procedure. The minimum followup was 14 months (mean, 30 months; range, 14-38 months). The mean change in ulnar variance was -1.29 mm. Patients showed radiographic healing by a mean of 11 weeks. Our preliminary results suggest the cartilage-retaining wafer resection osteotomy may be an effective way to unload the ulnocarpal joint without requiring internal fixation or destruction of the distal ulna cartilage.

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Mar shortening osteotomy in posttraumatic ulnar impaction syndrome

Cited by 47 publications

References 13 publications

Mid-Term Results following Ulna Shortening Osteotomy

Mid-Term Results following Ulna Shortening Osteotomy

Ulnar Shortening Osteotomy for Ulnar-Sided Wrist Pain

Cartilage-retaining Wafer Resection Osteotomy of the Distal Ulna

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