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Comparing radial lengthening osteotomy with ulnar shortening osteotomy to treat ulnar impaction syndrome after distal radius fracture malunion

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A Correction to this article was published on 02 December 2021

This article has been updated

Abstract

Introduction

Distal radius mal-unions often cause radius shortening and ulnar impaction syndrome. The modern treatments of ulnar impaction syndrome following distal radius mal-union are ulnar shortening osteotomy (USO) and distal radius lengthening osteotomy (DRLO). However, there are few studies to compare long-term outcomes of these two treatments. This study compares isolated USO to DRLO for the treatment of ulnar impaction syndrome following distal radius mal-union.

Materials and Methods

We retrospectively reviewed 68 patients with extra-articular distal radius mal-unions treated by isolated USO in 36 patients and DRLO in 32 patients. Pain visual analog scale (VAS), wrist motion, grip strength, radiographic parameters including sigmoid inclination, DASH score, and perioperative complications were analyzed. Mean follow-up was 62.6 months.

Results

The postoperative VAS scores for pain on exertion were less in the DRLO group than the USO group (1.2 vs. 2.8, p = 0.02). The DASH scores were 16.7 and 29.8 in the DRLO and USO groups, respectively (p = 0.02). The reduction of pain and improvement of function showed significantly better in the DRLO group. The mean operative time was shorter in the USO group. Most of the sigmoid inclinations were changed in DRLO. There were two re-operations following USO for painful nonunion and two patients had subsequent DRUJ osteoarthritis at the last follow-up.

Conclusion

Although both treatments improved range of motion, grip strength, and VAS for pain, DRLO was found in better reduction of pain and improvement of function. USO is a simpler procedure with a shorter operative time but it has an increased potential to cause subsequent osteoarthritis of the DRUJ as its incongruity of DRUJ after USO especially in reverted inclination. DRLO can be a preferred method for treating USWP in relevant distal radial mal-union.

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Beitou Distinct, Taipei, 112, Taiwan

    Hsuan-Hsiao Ma, Hui-Kuang Huang, Yi-Chao Huang, Ming-Chau Chang & Jung-Pan Wang

  2. Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Hsuan-Hsiao Ma, Hui-Kuang Huang, Yi-Chao Huang, Ming-Chau Chang & Jung-Pan Wang

  3. Department of Orthopaedics, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan

    Hui-Kuang Huang

  4. Chung Hwa University of Medical Technology, Tainan, Taiwan

    Hui-Kuang Huang

  5. Department of Orthopedics, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan

    Yi-Chou Chen

  6. Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan

    Yi-Chou Chen

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  1. Hsuan-Hsiao Ma
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  2. Yi-Chou Chen
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Corresponding author

Correspondence to Jung-Pan Wang.

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Conflict of interest

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Ethical approval

Taipei Veterans General Hospital approved the human protocol for this investigation, and each author certifies that all investigations were conducted in conformity with ethical principles of research. The study was done at Taipei Veterans General Hospital, Taipei, Taiwan.

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The original online version of this article was revised: Affiliation details of Yi-Chou Chen and Yi-Chao Huang were incorrect.

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Ma, HH., Chen, YC., Huang, HK. et al. Comparing radial lengthening osteotomy with ulnar shortening osteotomy to treat ulnar impaction syndrome after distal radius fracture malunion. Arch Orthop Trauma Surg 142, 525–531 (2022). https://doi.org/10.1007/s00402-021-04247-7

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  • DOI: https://doi.org/10.1007/s00402-021-04247-7

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