HSS Journal ®

, Volume 10, Issue 1, pp 13–17 | Cite as

Mid-Term Results Following Ulna Shortening Osteotomy

  • Duretti T. Fufa
  • Michele G. Carlson
  • Ryan P. Calfee
  • Nandita Sriram
  • Richard H. Gelberman
  • Andrew J. Weiland
Original Article

Abstract

Background

Successful short-term results of diaphyseal ulna shortening osteotomy are documented in both idiopathic and post-traumatic ulnar impaction.

Questions/Purposes

The purpose of this study was to evaluate the mid-term outcomes of ulnar shortening osteotomy with respect to radiographic assessment of corrected alignment and healing as well as patient satisfaction, pain, and function assessed using the Disability of the Arm, Shoulder, and Hand (DASH) score.

Patients and Methods

This retrospective case series included follow-up of 33 patients with ulnar impaction syndrome following ulna shortening osteotomy at a minimum of 5 years. Patient-rated outcomes included satisfaction, pain assessment, and DASH score. Pre- and postoperative radiographs were reviewed to quantify ulnar variance and osteotomy union rates. Subsequent operations were also recorded.

Results

Average follow-up was 10 years (range, 5–20 years). Eighty-eight percent of patients reported they were either satisfied or very satisfied with the procedure and 91% reported they would have the same procedure again. Average pain rating was 2 out of 10 at final follow-up. The mean DASH score was 11 (range, 0–39). Removal of hardware was performed in 10 patients (30%). The overall rate of reoperation was 45%.

Conclusions

Ulna shortening osteotomy yields reliable midterm satisfaction and pain relief in patients with idiopathic and post-traumatic ulnar impaction syndrome. Reoperation is frequent. Consistent with results of short-term follow-up, plate irritation requiring removal remains the most common cause for reoperation over time.

Keywords

ulna impaction shortening osteotomy 

Supplementary material

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REFERENCES

  1. 1.
    Baek GH, Chung MS, Lee YH, Gong HS, Lee S, Kimg HH. Ulnar shortening osteotomy in idiopathic ulnar impaction syndrome. J Bone Joint Surg Am. 2005; 87A: 2649-2654.CrossRefGoogle Scholar
  2. 2.
    Bernstein MA, Nagle DJ, Martinez A, Stogin JM Jr, Wiedrich TA. A comparison of combined arthroscopic triangular fibrocartilage complex debridement and arthroscopic wafer distal ulna resection versus arthroscopic triangular fibrocartilage complex debridement and ulnar shortening osteotomy for ulnocarpal abutment syndrome. Arthroscopy. 2004; 20: 392-401.PubMedCrossRefGoogle Scholar
  3. 3.
    Chen NC, Wolfe SW. Ulna shortening osteotomy using a compression device. J Hand Surg. 2003; 28: 88-93.CrossRefGoogle Scholar
  4. 4.
    Chun S, Palmer AK. The ulnar impaction syndrome: follow-up of ulnar shortening osteotomy. J Hand Surg. 1993; 18A: 46-53.CrossRefGoogle Scholar
  5. 5.
    Constantine KJ, Tomaino MM, Herndon JH, Sotereanos DG. Comparison of ulnar shortening osteotomy and the wafer resection procedure as treatment for ulnar impaction syndrome. J Hand Surg. 2000; 25A: 55-60.CrossRefGoogle Scholar
  6. 6.
    Fricker R, Pfeiffer KM, Troeger H. Ulnar shortening osteotomy in posttraumatic ulnar impaction syndrome. Arch Orthop Trauma Surg. 1996; 115: 158-161.PubMedCrossRefGoogle Scholar
  7. 7.
    Goldfarb CA, Strauss NL, Wall LB, Calfee RP. Defining ulnar variance in the adolescent wrist: measurement technique and interobserver reliability. J Hand Surg. 2011; 36: 272-277.CrossRefGoogle Scholar
  8. 8.
    Hunsaker FG, Cioffi DA, Amadio PC, Wright JG, Caughlin B. The American academy of orthopaedic surgeons outcomes instruments. Normative values from the general population. J Bone Joint Surg Am. 2002; 84: 208-214.PubMedGoogle Scholar
  9. 9.
    Loh YC, Abbeele VD, Stanley JK, Trail IA. The results of ulnar shortening for ulnar impaction syndrome. J Hand Surg (Br). 1999; 24B: 316-320.CrossRefGoogle Scholar
  10. 10.
    Milch H. Cuff resection of the ulna for malunited Colles' fracture. J Bone Joint Surg Am. 1941; 23: 311-313.Google Scholar
  11. 11.
    Miura T, Firoozbakhsh K, Cheema T, Moeim MS, Edmunds M, Meltzer S. Dynamic effects of joint-leveling procedure on pressure at the distal radioulnar joint. J Hand Surg. 2005; 30A: 711-718.CrossRefGoogle Scholar
  12. 12.
    Moermans A, Degreef I, DeSmet L. Ulnar shortening osteotomy for ulnar ideopathic impaction syndrome. Scand J Plast Reconstr Surg Hand Surg. 2007; 41: 310-314.PubMedCrossRefGoogle Scholar
  13. 13.
    Nishiwaki M, Nakamura T, Nagura T, Toyama Y, Ikegami H. Ulnar-shortening effect on distal radioulnar joint pressure: a biomechanical study. J Hand Surg. 2008; 33A: 198-205.CrossRefGoogle Scholar
  14. 14.
    Rayhack JM, Gasser SI, Latta LL, Ouellette EA, Milne EL. Precision oblique osteotomy for shortening of the ulna. J Hand Surg. 1993; 18: 908-918.CrossRefGoogle Scholar
  15. 15.
    Sachar K. Ulnar-sided wrist pain: evaluation and treatment of triangular fibrocartilage complex tears, ulnocarpal impaction syndrome, and lunotriquetral ligament tears. J Hand Surg. 2008; 33: 1669-1679.CrossRefGoogle Scholar
  16. 16.
    Sammer DM, Rizzo M. Ulnar impaction. Hand Clin. 2010; 26: 549-557.PubMedCrossRefGoogle Scholar
  17. 17.
    Steyers CM, Blair WF. Measuring ulnar variance: a comparison of techniques. J Hand Surg. 1989; 14: 607-612.CrossRefGoogle Scholar
  18. 18.
    Sunil TM, Wolff TW, Scheker LR, McCabe SJ, Gupta A. A comparative study of ulnar-shortening osteotomy by the freehand technique versus the Rayhack technique. J Hand Surg. 2006; 31: 252-257.CrossRefGoogle Scholar

Copyright information

© Hospital for Special Surgery 2013

Authors and Affiliations

  • Duretti T. Fufa
    • 1
  • Michele G. Carlson
    • 1
  • Ryan P. Calfee
    • 2
  • Nandita Sriram
    • 1
  • Richard H. Gelberman
    • 2
  • Andrew J. Weiland
    • 1
    • 2
  1. 1.Hospital for Special SurgeryNew YorkUSA
  2. 2.Washington UniversitySt LouisUSA

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