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Ulnocarpal impaction syndrome: treatment with a transverse ulnar shortening osteotomy from an ulnodorsal approach

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Abstract

Introduction

Ulnocarpal impaction syndrome is a common cause of chronic ulnar-sided wrist pain. The distal ulnar shortening osteotomy addresses the often present positive ulnar variance and therefore relieves the excessive load on the ulnocarpal joint. In the present study, the results of a technique that uses an ulnodorsal approach with a compression device and a transverse osteotomy are presented and compared to other techniques.

Materials and methods

This retrospective study includes 92 wrists with an ulnocarpal impaction syndrome, which were treated with an ulnar shortening osteotomy. The mean duration of postoperative follow-up was 50 months.

Results

The mean ulnar variance was 2.17 ± 1.56 mm preoperatively and after the ulnar shortening osteotomy −1.36 ± 1.67 mm (p < 0.05). Radiological consolidation of the osteotomy could be shown in 91 wrists 6 months postoperatively. Patients rated the preoperative pain level at a VAS 7.9 ± 1.7 which decreased to a of VAS 2.4 ± 2.5 (p < 0.05). 19 patients complained of mechanical irritation. There was no neurological irritation.

Conclusion

It could be shown that the distal ulnar shortening osteotomy by a transverse osteotomy using a compression device and an ulnodorsal approach has a low complication rate. It is comparable to the oblique osteotomy in effectiveness and safety.

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Conflict of interest

All named authors hereby declare that they have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Elbow, Hand and Microsurgery, Immanuel-Hospital, Königstrasse 63, 14109, Berlin, Germany

    Martin Lautenbach & Nicole-Simone Schmidt

  2. Center for Hand and Functional Microsurgery, University Medicine Greifswald, Sauerbruchstraße, 17475, Greifswald, Germany

    Alexander Zach & Andreas Eisenschenk

  3. Department of Hand, Replantation and Microsurgery, Unfallkrankenhaus Berlin, Warener Str. 7, 12683, Berlin, Germany

    Michael Millrose & Frank Eichenauer

Authors
  1. Martin Lautenbach
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  2. Michael Millrose
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  3. Nicole-Simone Schmidt
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  4. Alexander Zach
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  5. Frank Eichenauer
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  6. Andreas Eisenschenk
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Correspondence to Michael Millrose.

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Lautenbach, M., Millrose, M., Schmidt, NS. et al. Ulnocarpal impaction syndrome: treatment with a transverse ulnar shortening osteotomy from an ulnodorsal approach. Arch Orthop Trauma Surg 134, 881–885 (2014). https://doi.org/10.1007/s00402-014-1976-x

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  • DOI: https://doi.org/10.1007/s00402-014-1976-x

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