Ulnar Shortening Osteotomy With a Premounted Sliding-Hole Plate

Kitzinger, Hugo B.; Karle, B.; Löw, Steffen; Krimmer, H.

doi:10.1097/01.sap.0000250835.72396.48

Cited by 39 publications

(41 citation statements)

References 17 publications

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“…These findings are consistent with those of previous studies [19,25]. Kitzinger et al [19] reported that the DASH and grip strength improved but that wrist ROM was unchanged after ulnar shortening osteotomy for ulnar impaction syndrome, whereas Moermans et al [25] found that the DASH and wrist ROM were improved but grip strength was unchanged. These inconsistencies between reports are presumably the result of the minor improvements observed in terms of grip strength and wrist ROMs after surgery.…”

Section: Discussionsupporting

confidence: 83%

“…In two studies, DASH scores were used as outcome measures after ulnar shortening osteotomy for ulnar impaction syndrome [19,25]. The PRWE system was designed to quantify the outcomes of wrist-specific injuries or disease and has been widely used as an outcome measure for distal radius fractures [1,12].…”

Section: Discussionmentioning

confidence: 99%

“…The surgical procedures were performed as previously described [2,19] with a six-hole low-contact dynamic compression plate (Synthes, Paoli, PA, USA) or seven-hole recon plate (Synthes) using transverse osteotomy. Postoperatively, patients were treated with a short arm splint for the first 4 weeks.…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have shown that ulnar shortening osteotomy generally has succeeded at decreasing pain and increasing functional ability in idiopathic ulnar impaction syndrome [2,5,6,19,22,25,29], but clinician-rated outcome measurements (instead of patient-reported questionnaires) have been used in the majority of these studies.…”

Section: Introductionmentioning

confidence: 99%

“…The DASH questionnaire is one of the most commonly used self-reported instruments for upper extremity disease and injury [15], and ulnar shortening osteotomy for ulnar impaction syndrome has been reported to improve DASH scores [19,25]. The Patient-Rated Wrist Evaluation (PRWE) questionnaire [23] was developed to specifically reflect wrist pain and function, but to date, it has not been used as an outcome measure of ulnar shortening osteotomy for ulnar impaction syndrome.…”

Section: Introductionmentioning

confidence: 99%

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Comparative Responsiveness and Minimal Clinically Important Differences for Idiopathic Ulnar Impaction Syndrome

Kim

Park

2013

Clinical Orthopaedics &Amp; Related Research

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Background Patient-reported questionnaires have been widely used to predict symptom severity and functional disability in musculoskeletal disease. Importantly, questionnaires can detect clinical changes in patients; however, this impact has not been determined for ulnar impaction syndrome. Questions/purposes We asked (1) which of Patient-Rated Wrist Evaluation (PRWE), DASH, and other physical measures was more responsive to clinical improvements, and (2) what was the minimal clinically important difference for the PRWE and DASH after ulnar shortening osteotomy for idiopathic ulnar impaction syndrome. Methods All patients who underwent ulnar shortening osteotomy between March 2008 and February 2011 for idiopathic ulnar impaction syndrome were enrolled in this study. All patients completed the PRWE and DASH questionnaires, and all were evaluated for grip strength and wrist ROM, preoperatively and 12 months postoperatively. We compared the effect sizes observed by each of these instruments. Effect size is calculated by dividing the mean change in a score of each instrument during a specified interval by the standard deviation of the baseline score. In addition, patient-perceived overall improvement was used as the anchor to determine the minimal clinically important differences on the PRWE and DASH 12 months after surgery. Results The average score of each item except for wrist flexion and supination improved after surgery. The PRWE was more sensitive than the DASH or than physical measurements in detecting clinical changes. The effect sizes and standardized response means of the outcome measures were as follows: PRWE (1.51, 1.64), DASH (1.12, 1.24), grip strength (0.59, 0.68), wrist pronation (0.33, 0.41), and wrist extension (0.28, 0.36). Patient-perceived overall improvement and score changes of the PRWE and DASH correlated significantly. Minimal clinically important differences were 17 points (of a possible 100) for the PRWE and 13.5 for the DASH (also of 100), and minimal detectable changes were 7.7 points for the PRWE and 9.3 points for the DASH. Conclusions Although the PRWE and DASH were highly sensitive to clinical changes, the PRWE was more sensitive in terms of detecting clinical changes after ulnar shortening osteotomy for idiopathic ulnar impaction syndrome. A minimal change of 17 PRWE points or 13.5 DASH points was necessary to achieve a benefit that patients perceived as clinically important. The minimal clinically important differences using these instruments were higher than the values produced by measurement errors.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Comparative Responsiveness and Minimal Clinically Important Differences for Idiopathic Ulnar Impaction Syndrome

Kim

Park

2013

Clinical Orthopaedics &Amp; Related Research

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Ulnar shortening with the ulna osteotomy locking plate

Schmidle

Arora

Gabl

2012

Oper Orthop Traumatol

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Sixteen ulnar shortening osteotomies were performed in 15 patients (6 men, 9 women, average age 49 years) and evaluated retrospectively. In 10 cases a trauma-related pathology was the indication for the procedure. The average follow-up time was 53 weeks (range 12-93 weeks). Bone union was observed at a median of 10 weeks (range 6-33 weeks). Overall good clinical results could be achieved with an average shortening of 3.7 mm (range 2.1-16 mm). In this series, there was one nonunion.

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