Ulnar shortening osteotomy after Colles fracture

Abstract

Ulnar shortening is well accepted in the treatment of ulnar abutment but less so in patients with a shortened radius and ulnar-sided wrist pain as a result of a Colles fracture. Sixteen patients with pain and reduced range of movement (ROM) and a median preoperative ulnar positive variance of 5 mm (range 0.5-11) had 17 osteotomies. Nine were male and seven female with a median age of 35 (range 15-55) years were operated on. Fifteen patients with 16 osteotomies could be reached for follow-up. The ulna was shortened by a median of 4.5 mm (range 3-12). The median pain score was reduced by 3 points (range 0-5). Postoperative ROM was improved in nine, unchanged in six, and reduced in one wrists. There were four complications: one re-fracture, two transient paraesthesiae, and one superficial infection. Seven of the patients regarded the result as excellent, six as good, three as fair, and none regarded it as poor. Thirteen of the 16 would have chosen the operation again, three would not.

Influence of Plate Size and Design upon Healing of Ulna-Shortening Osteotomies

“…Factors determining the outcome after ulna-shortening osteotomy were longer duration of symptoms preoperatively and workers' compensation. 22 Reported other less frequent complications were overcorrection resulting in disorders of the DRUJ, 17 osteoarthritic changes, 23 numbness/paresthesia over the dorsum of the wrist innervated by the dorsal sensory cutaneous branch of ulnar nerve, 24 superficial infection, 25 fractures through the osteotomy site after early plate removal, 7,21,23 and CRPS. 23 The latter was the second most frequent complication in our study.…”

What Surgical Technique to Perform for Isolated Ulnar Shortening Osteotomy After Distal Radius Malunion: A Systematic Review

“…7,[13][14][15][20][21][22][23][24][25] Ten populations (n = 153) underwent diaphyseal osteotomy, [13][14][15]20,[22][23][24][25][26] 1 population (n = 16) underwent metaphyseal osteotomy, 13 and in 1 population (n = 16) it was unclear whether it involved a diaphyseal or metaphyseal osteotomy. 21 Six cohorts underwent a diaphyseal oblique osteotomy(n = 111), 14,15,20,23,25,26 2 cohorts underwent a diaphyseal step-cut osteotomy (n = 22), 13,14 3 cohorts underwent a transverse osteotomy (n = 36), 21,22,24 and 1 cohort underwent a curved metaphyseal osteotomy. 13 In all cohorts, a compression plate was used except for the metaphyseal cohort where 2 screws were used.…”

“…[13][14][15][21][22][23][24][25] Patient-rated outcomes were reported in 11 cohorts using different questionnaires, such as Quick Disabilities of the Arm, Shoulder, and Hand; patient-rated wrist evaluation; Mayo wrist score; and Chun and Palmer grading score. 7,[13][14][15][21][22][23][24][25] Radiographic outcomes were reported in 7 cohorts. 7,13,14,21,23…”

“…In addition to the raw data presented in 2 articles, 1 author provided deidentified raw study data. [13][14][15] Extracted data involved the following variables: (1) study design; (2) study participants; (3) details on surgical intervention (ie, surgical technique, ulnar shortening in millimeters); (4) duration of follow-up; (5) complications; (6) functional results (ie, ROM, grip strength, patient-reported outcome); and (7) radiographic results (ie, ulnar variance). In the study with multiple follow-up measurements, the data from the last follow-up were collected, 15 and the studies with 2 or more treatment arms were analyzed as separate studies, due to the purpose of this review.…”

“…In the study with multiple follow-up measurements, the data from the last follow-up were collected, 15 and the studies with 2 or more treatment arms were analyzed as separate studies, due to the purpose of this review. 13,14…”