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Ulnar shortening osteotomy as a treatment of symptomatic ulnar impaction syndrome after malunited distal radius fractures

Archives of Orthopaedic and Trauma Surgery volume 140, pages 681–695 (2020)Cite this article

Abstract

A malunited distal radius fracture can lead to symptomatic ulnar impaction syndrome, which is a common cause for ulnar-sided wrist pain. If conservative treatment fails and symptoms persist after an arthroscopic ulnocarpal debridement, ulnar shortening osteotomy (USO) is the treatment of choice. Since the first USO described by Milch in 1941 after a malunited Colles fracture, many techniques have been described varying in surgical approach, type of osteotomy and osteosynthesis material used. Many studies demonstrated good to very good functional results after USO, reporting, however, a delayed union or non-union rate up to 18%. A modern, low profile, locking plate showed in our short-term study very good functional results and no implant-associated complications, in particular no non-union.

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Abbreviations

CT:

Computed tomography

DASH score:

Disabilities of the arm, shoulder, and hand score

DRF:

Distal radius fracture

DRUJ:

Distal radioulnar joint

ECU:

Extensor carpi ulnaris

FCU:

Flexor carpi ulnaris

LT:

Lunotriquetral

MRI:

Magnetic resonance imaging

ROM:

Range of motion

TFCC:

Triangular fibrocartilage complex

USO:

Ulnar shortening osteotomy

UIS:

Ulnar impaction syndrome

VAS:

Visual analogue scale

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  1. Department for Plastic, Hand and Reconstructive Surgery, BG Trauma Center Frankfurt Am Main, FESSH Trauma Center, Academic Hospital of the Goethe University Frankfurt am Main, Friedberger Landstrasse 430, 60389, Frankfurt am Main, Germany

    Athanasios Terzis, S. Koehler, J. Sebald & M. Sauerbier

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  1. Athanasios Terzis
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Correspondence to Athanasios Terzis.

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Sauerbier M has a research and development contract with Medartis, Basel/Switzerland. The co-authors have no conflict of interest.

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Terzis, A., Koehler, S., Sebald, J. et al. Ulnar shortening osteotomy as a treatment of symptomatic ulnar impaction syndrome after malunited distal radius fractures. Arch Orthop Trauma Surg 140, 681–695 (2020). https://doi.org/10.1007/s00402-020-03374-x

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Keywords

  • Ulnar impaction syndrome
  • Ulnar shortening osteotomy
  • Ulnar variance
  • Malunion
  • Distal radius fracture