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Ulnar shortening osteotomy for ulnar ideopathic impaction syndrome
Annelies Moermans1, Ilse Degreef, Luc De Smet
1Department of Orthopaedic Surgery, U.Z. Pellenberg, Lubbeek, Pellenberg, Belgium.
Summary
Ulnar shortening osteotomy effectively treats ulnar impaction syndrome, improving grip strength and reducing pain. This surgical procedure offers significant functional recovery for wrist conditions.
Area of Science:
- Orthopedic Surgery
- Hand and Wrist Surgery
- Musculoskeletal Disorders
Background:
- Ulnar impaction syndrome, both static and dynamic, presents a challenge in hand and wrist surgery.
- Ulnar variance, the relative length of the ulna compared to the radius, is a key factor in this condition.
- Conservative treatments often yield suboptimal results, necessitating surgical intervention.
Purpose of the Study:
- To evaluate the efficacy of ulnar shortening osteotomy in managing ulnar impaction syndrome.
- To assess functional outcomes, including grip strength, DASH scores, and range of motion, post-surgery.
- To explore potential correlations between patient demographics, surgical technique, anatomical factors, and treatment success.
Main Methods:
- Twenty-eight patients underwent ulnar shortening osteotomy, with bone shortening averaging 3.5 mm.
- Ulnar variance was pre-operatively assessed via anteroposterior radiographs.
- Patient-reported outcomes (DASH score) and objective measures (grip strength, range of motion) were recorded at a mean 29-month follow-up.
Main Results:
- Significant improvements were observed in mean grip strength (67% to 75%) and DASH scores (40 to 26).
- Mean range of motion increased from 80% to 88% post-surgery.
- Consolidation was confirmed in all patients; factors like smoking, age, osteotomy type, hand dominance, and sex did not impact outcomes.
Conclusions:
- Ulnar shortening osteotomy is a valuable treatment for relieving ulnocarpal impingement symptoms.
- The procedure leads to substantial improvements in wrist function and patient-reported outcomes.
- Anatomical variations of the distal radioulnar joint and sigmoid notch did not correlate with functional results.
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