Cartilage-retaining Wafer Resection Osteotomy of the Distal Ulna

Barry, Jason A.; Macksoud, Wadih S.

doi:10.1007/s11999-007-0059-5

Cited by 13 publications

(7 citation statements)

References 16 publications

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“…Advantages of OWP include the preservation of the native distal radioulnar joint (DRUJ), the ability to openly address TFCC pathology, and the avoidance of internal fixation (Schuurman and Bos, 1995). Although usually only the sigmoid notch cartilage is preserved, a method has been described that retains the distal ulnar cartilage (Barry and Macksoud, 2008). Similar to AWP, it has been described that a positive UV >4 mm is a contraindication to OWP for UIS (Feldon et al, 1992), and the main complication is revision to open surgery (Tomaino and Shah, 2001).…”

Section: Discussionmentioning

confidence: 99%

Operative treatment of ulnar impaction syndrome: a systematic review

Stockton

Pelletier

Pike

2014

J Hand Surg Eur Vol

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This article critically and systematically reviews the surgical treatments for ulnar impaction syndrome. Three types of treatments currently exist: arthroscopic wafer procedure, open wafer procedure, and ulna shortening osteotomy. A total of 36 articles were included from searching the electronic databases PubMed MEDLINE, Ovid MEDLINE, and Ovid EMBASE. Studies were evaluated for quality using the Modified Detsky Score. Of these, 14 articles had a Modified Detsky Score of 6/10 or higher. Satisfaction rates were 100% for arthroscopic wafer procedure, 89% for open wafer procedure, and 84% for ulna shortening osteotomy. The percentage of participants reporting an excellent or good outcome was 82% for arthroscopic wafer procedure, 87% for open wafer procedure, and 76% for ulna shortening osteotomy. In conclusion, available evidence shows that arthroscopic wafer procedure and open wafer procedure may be viable alternatives to the more popular ulna shortening osteotomy, but clinical superiority is yet to be established. Future research should focus on prospective cohort methods and should report participant outcomes using validated scoring methods.

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Section: Discussionmentioning

confidence: 99%

Operative treatment of ulnar impaction syndrome: a systematic review

Stockton

Pelletier

Pike

2014

J Hand Surg Eur Vol

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“…We believe that our algorithm is applicable for ulnar wrist pain. The results of ulnar shortening osteotomy have been mixed, 48 and a prospective study is warranted to clarify factors affecting the clinical results.…”

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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“…All patients reported a reduction of pain. The average postoperative VAS score for pain was 23 moderate difference, and significant difference. It was graded as comparable if the difference in ROM is less than 10 degrees, in grip strength is less than 5 kg, and in pronation and supination strength is less than 10 kg.…”

Section: Resultsmentioning

confidence: 84%

“…[19][20][21][22] The most popular methods are the open or arthroscopic wafer procedure and the diaphyseal shortening osteotomy with plate and screw fixation. [23][24][25][26][27] This article describes the oblique metaphyseal shortening osteotomy of the distal ulna, starting proximal-ulnar, and ending distal-radial just proximal to the ulnar head, respecting an inclination between 30 and 45 degrees. The surface contact area between the fragments can be increased with a more inclined osteotomy.…”

Section: Discussionmentioning

confidence: 99%

The Oblique Metaphyseal Shortening Osteotomy of the Distal Ulna: Surgical Technique and Results of Ten Patients

Benis

Goubau

Mermuys³

et al. 2016

Jnl Wrist Surg

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Background Ulnocarpal abutment is a common condition following distal radius fractures. There are different surgical methods of treatment for this pathology: open and arthroscopic wafer procedure or an ulnar shortening osteotomy. We describe an oblique metaphyseal shortening osteotomy of the distal ulna using two cannulated headless compression screws. We report the results of 10 patients treated with this method. Materials and Methods Out of 17 patients, 10 could be reviewed retrospectively for this study. Patient-rated outcomes were measured using the VAS (visual analogue scale) for pain, PRWHE (patient-rated wrist and hand evaluation) survey, and Quick-DASH (disability of arm, shoulder and hand) survey for functional outcomes. At the review we measured the range of motion (ROM) of the wrist (extension and flexion, ulnar and radial deviation, pronation and supination). Grip strength, pronation, and supination strength of the forearm was measured using a calibrated hydraulic dynamometer. ROM and strength of the affected wrist was compared with ROM and strength of the unaffected wrist. Surgical Procedure Oblique long metaphyseal osteotomy of the distal ulna (from proximal-ulnar to distal-radial), fixed with two cannulated headless compression screws. Results The average postoperative VAS score for pain was 23.71 (standard deviation [SD] of 30.41). The average postoperative PRWHE score was 32.55 (SD of 26.28). The average postoperative Quick-DASH score was 28.65 (SD of 27.21). The majority of patients had a comparable ROM and strength between the operated side and the nonoperated side. Conclusion This surgical technique has the advantage of reducing the amount of hardware and to decrease the potential hinder caused by it on medium term. Moreover, the incision remains smaller, and the anatomic metaphyseal localization of the osteotomy potentially allows a better and rapid healing.

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Cartilage-retaining Wafer Resection Osteotomy of the Distal Ulna

Cited by 13 publications

References 16 publications

Operative treatment of ulnar impaction syndrome: a systematic review

Operative treatment of ulnar impaction syndrome: a systematic review

Ulnar Shortening Osteotomy for Ulnar-Sided Wrist Pain

The Oblique Metaphyseal Shortening Osteotomy of the Distal Ulna: Surgical Technique and Results of Ten Patients

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