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Ulnar shortening osteotomy in posttraumatic ulnar impaction syndrome
R Fricker1, K M Pfeiffer, H Troeger
1Abteilung fur Hand- und periphere Nervenchirurgie, Departement Chirurgie, Kantonsspital, Basel, Switzerland.
Archives of Orthopaedic and Trauma Surgery
|January 1, 1996
Summary
Ulnar shortening osteotomy effectively treats posttraumatic ulnar impaction syndrome, with 89% patient satisfaction. However, results depend on the distal radioulnar joint
Area of Science:
- Orthopedic Surgery
- Hand and Wrist Surgery
- Traumatology
Background:
- Posttraumatic ulnar impaction syndrome can cause significant wrist pain and dysfunction.
- Contributing factors include distal radius malunions and distal ulna fractures.
- Surgical intervention is often necessary to restore function.
Purpose of the Study:
- To evaluate the outcomes of ulnar shortening osteotomy in patients with posttraumatic ulnar impaction syndrome.
- To identify factors influencing surgical success.
- To assess the efficacy of dynamic compression plate fixation.
Main Methods:
- Twenty-eight patients with posttraumatic ulnar impaction syndrome underwent ulnar shortening osteotomy (3-15 mm).
- Contributing factors were documented, including distal radius malunions and ulnar fractures.
- Outcomes were assessed using Chun's modification of the Gartland-Werley score at an average 20-month follow-up.
Main Results:
- 89% of patients reported satisfaction with the ulnar shortening osteotomy.
- Functional outcomes included 3.5% excellent, 39.5% good, 39.5% fair, and 17.5% poor results.
- Degenerative changes in the distal radioulnar joint correlated with fair and poor outcomes.
Conclusions:
- Ulnar shortening osteotomy is a viable treatment for posttraumatic ulnar impaction syndrome, particularly with an intact distal radioulnar joint.
- Dynamic compression plate fixation allows early mobilization and has a low complication rate.
- Transverse osteotomy is as effective as oblique osteotomy without increased technical demand.