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Step-cut distal ulnar-shortening osteotomy.
Nickolaos A Darlis1, Italo C Ferraz, Robert W Kaufmann
1Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, PA 15212, USA.
The Journal of Hand Surgery
|September 27, 2005
Summary
A novel step-cut ulnar-shortening osteotomy technique using a lag screw and palmar plate offers a simple and effective solution. This method ensures solid bone union and allows for early wrist mobilization, addressing ulnar-impaction syndrome and ulnar-plus variance.
Area of Science:
- Orthopedic Surgery
- Hand and Wrist Surgery
Background:
- Ulnar-shortening osteotomies are used to treat conditions like ulnar-impaction syndrome.
- Various techniques exist, but challenges in achieving optimal outcomes persist.
Purpose of the Study:
- To describe a simple step-cut ulnar-shortening osteotomy technique.
- To evaluate its efficacy in stabilizing the ulna with a lag screw and palmar plate.
Main Methods:
- A step-cut osteotomy was performed on 29 patients with ulnar-impaction syndrome or ulnar-plus variance.
- Fixation was achieved using a lag screw and a 3.5-mm palmarly placed neutralization plate.
- Preoperative ulnar variance ranged from +1 mm to +6 mm.
Main Results:
- All 29 osteotomies achieved solid, uneventful healing.
- The mean postoperative ulnar variance was +0.2 mm.
- Three patients required hardware removal.
Conclusions:
- The step-cut technique provides excellent bone-to-bone contact and rotational control.
- Stable fixation allows for early wrist mobilization.
- Palmar plate placement minimizes the need for removal, making it a simple and effective ulnar shortening procedure.