Ulna shortening osteotomy for ulnar impaction syndrome: Impact of distal radioulnar joint morphology on clinical outcome

Roulet, Steven; Gubbiotti, Laura; Lakhal, Walid; Chaves, Camilo; Marteau, Émilie; Laulan, J.; Bacle, Guillaume

doi:10.1016/j.otsr.2021.102970

Cited by 9 publications

(7 citation statements)

References 36 publications

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“…Hassan et al 8 reported similar results in 20 patients with previous distal radius fractures who had an improvement of 53 points on the PRWHE after a mean follow-up of 24 months. Our mean late-follow up PRWHE score (mean = 19) is comparable to results from Roulet et al, 7 who reported a mean PRWHE score of 22 points in 25 patients after a mean follow-up of 5.3 years, and seems better than the study from de Runz et al, 5 who reported a mean score of 33 in 46 patients after a mean follow-up of 5.2 years. In addition to showing that long-term outcomes were similar to previous reports, our study also revealed no signs of functional deterioration at long-term follow-up compared to short-term outcomes.…”

Section: Discussionsupporting

confidence: 85%

“…De Runz et al 5 found that patients with DRUJ osteoarthritis had worse PRWHE scores than patients without, 5 and other studies suggested that the DRUJ morphology affected the outcome. 4 , 6 , 7 However, this study did not have radiological data at late follow-up, and DRUJ morphology could not reliably be assessed. Future prospective studies should further investigate predictors for the long-term patient-reported outcome after USO.…”

Section: Discussionmentioning

confidence: 94%

“…Ulna shortening osteotomy (USO) is an established treatment option for patients with ulnar impaction syndrome (UIS). [1][2][3] Previous studies reported good results, but mainly focused on radiological outcomes [4][5][6][7] or clinician-reported outcome measures. 4 However, these studies often lacked patientreported outcome measures (PROMs), preoperative measurements, 5 or had a small sample size.…”

Section: Introductionmentioning

confidence: 99%

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Long-term outcomes after ulna shortening osteotomy: a mean follow-up of six years

Teunissen¹,

Oest

Selles

et al. 2022

Bone & Joint Open

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Aims The primary aim of this study was to describe long-term patient-reported outcomes after ulna shortening osteotomy for ulna impaction syndrome. Methods Overall, 89 patients treated between July 2011 and November 2017 who had previously taken part in a routine outcome evaluation up to 12 months postoperatively were sent an additional questionnaire in February 2021. The primary outcome was the Patient-Rated Wrist and Hand Evaluation (PRWHE) total score. Secondary outcomes included patient satisfaction with treatment results, complications, and subsequent treatment for ulnar-sided wrist pain. Linear mixed models were used to compare preoperative, 12 months, and late follow-up (ranging from four to nine years) PRWHE scores. Results Long-term outcomes were available in 66 patients (74%) after a mean follow-up of six years (SD 1). The mean PRWHE total score improved from 63 before surgery to 19 at late follow-up (difference in means (Δ) 44; 95% confidence interval (CI) 39 to 50; p = <0.001). Between 12 months and late follow-up, the PRWHE total score also improved (Δ 12; 95% CI 6 to 18; p = < 0.001). At late follow-up, 14/66 of patients (21%) reported a PRWHE total score of zero, whereas this was 3/51 patients (6%) at 12 months (p = 0.039). In all, 58/66 patients (88%) would undergo the same treatment again under similar circumstances. Subsequent treatment (total n = 66; surgical n = 57) for complications or recurrent symptoms were performed in 50/66 patients (76%). The most prevalent type of reoperation was hardware removal in 42/66 (64%), and nonunion occurred in 8/66 (12%). Conclusion Ulna shortening osteotomy improves patient-reported pain and function that seems to sustain at late follow-up. While satisfaction levels are generally high, reoperations such as hardware removal are common. Cite this article: Bone Jt Open 2022;3(5):375–382.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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Long-term outcomes after ulna shortening osteotomy: a mean follow-up of six years

Teunissen¹,

Oest

Selles

et al. 2022

Bone & Joint Open

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“…25 Early surgical intervention is recommended for UIS patients with concurrent DRUJ instability. 27 In a case series study, surgery was confirmed as a reliable method to improve UIS with DRUJ instability. Postoperatively, patients reported an average VAS score, Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and Patient-Rated Wrist Evaluation score of 0.7/10 (range, 0-4), 16.9 (range, 0-48), and 21.9 (range, 16.9-59)-all indicating significant improvements compared with preoperative values.…”

Section: Imaging Examinationmentioning

confidence: 97%

Guidelines for the Diagnosis and Treatment of Ulnar Impaction Syndrome (2024)

Xu,

Ho,

Nakamura

et al. 2024

J Wrist Surg

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Background: Ulnar impaction syndrome (UIS), also known as ulnar impaction or ulnar abutment, is a degenerative condition causing pain on the ulnar side of the wrist. It can lead to wrist bone necrosis, resulting in wrist joint stability disruption and a significant wrist function impairment. The global understanding of this condition varies, contributing to substantial differences in clinical outcomes. Purposes: This paper underscores the necessity of developing evidence-based clinical guidelines for UIS to guide clinicians in their diagnostic and therapeutic approaches. Methods: In collaboration with the Asian Pacific Wrist Association, a team of experts from various fields within the Hand Surgery Department at Huashan Hospital has collectively formulated the “Clinical Practice Guidelines for Ulnar Impaction Syndrome (2024)” (hereinafter referred to as the “Guidelines”). The development process adhered to the guidelines outlined in the World Health Organization's handbook for guideline development. Results: Ten key questions and 21 recommendations are formed. The Guidelines provide recommendations for UIS diagnosis, criteria for selecting conservative or surgical interventions, options for surgical procedures, and address various related issues. Conclusions: The collaborative effort aims to standardize clinical practices, enhance diagnostic accuracy, and improve treatment outcomes for individuals affected by UIS, with these recommendations intended to serve as a valuable reference for healthcare professionals.

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“…Therefore, surgery is still the main treatment for UIS. At present, the clinical surgical methods include ulnar shortening osteotomy (USO) 5 , arthroscopic wafer surgery 6 , and Sauve‐Kapandji surgery 7 . Among them, USO is the most commonly used in the clinic.…”

Section: Introductionmentioning

confidence: 99%

Clinical Study of Wrist Arthroscopy Combined with Oblique Ulnar Shortening Osteotomy in the Treatment of Ulnar Impaction Syndrome

Wang

Zhang

et al. 2022

Orthopaedic Surgery

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Objective To explore the clinical effects of wrist arthroscopy combined with oblique ulnar shortening osteotomy in the treatment of ulnar impaction syndrome. Methods This was a retrospective study of 60 patients with ulnar impaction syndrome who were admitted to our department from January 2016 to December 2019. According to different surgical methods, they were divided into an observation group and a control group, with 30 cases in each group. The control group was treated with oblique ulnar shortening osteotomy, and the observation group used wrist arthroscopy based on the control group. The two groups of patients were compared in terms of wrist function before and 12 months after surgery. We compared the Disabilities of the Arm, Shoulder, and Hand Score (DASH Score), Patient‐Rated Wrist Evaluation Score (PRWE Score), Visual Analog Score (VAS), and ulnar variation between the two groups at 12 months after surgery. The excellent and good rates by Mayo wrist score were compared between the two groups at the last follow‐up. Results All patients were followed up for 12–36 months, with an average of 14.5 months. Bone union was achieved at the oblique osteotomy of the ulna, with an average healing time of 13.6 weeks. The observation group was examined by wrist arthroscopy, and the triangular fibrocartilage complex (TFCC) Palmer classification was confirmed in three cases of type IIA, seven cases of type IIB, 14 cases of type IIC, and six cases of type IID. Compared with before surgery, the grip strength, flexion‐extension, ulnar radial deflection, and forearm rotation of the two groups of patients were significantly improved at 12 months after surgery. The DASH score, PRWE score, and VAS score of the observation group were better than those of the control group, and the difference in ulnar shortening length was not statistically significant between the two groups. The excellent and good rates of the observation group (93.3%) were better than those of the control group (87.5%) at the last follow‐up, and the difference was statistically significant. Conclusion Compared with oblique ulnar shortening osteotomy alone, combined wrist arthroscopy can better reduce the pain of patients with ulnar impaction syndrome, restore wrist function, and improve the excellent and good rates. Therefore, it is clinically worthy of promotion.

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Ulna shortening osteotomy for ulnar impaction syndrome: Impact of distal radioulnar joint morphology on clinical outcome

Cited by 9 publications

References 36 publications

Long-term outcomes after ulna shortening osteotomy: a mean follow-up of six years

Long-term outcomes after ulna shortening osteotomy: a mean follow-up of six years

Guidelines for the Diagnosis and Treatment of Ulnar Impaction Syndrome (2024)

Clinical Study of Wrist Arthroscopy Combined with Oblique Ulnar Shortening Osteotomy in the Treatment of Ulnar Impaction Syndrome

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