Abstract
Twenty-eight patients (average age 45 years) with posttraumatic ulnar impaction syndrome underwent ulnar shortening osteotomy of 3–15 mm. Contributing factors were malunited fractures of the distal radius in 20, diaphyseal fractures of the ulna and radius in 6, resection of the radial head and a traumatic tear of the triangular fibrocartilage in 1 patient each. Evaluation at an average follow-up of 20 months showed a high rate of satisfied patients (89%), but according to Chun's modification of the Gartland-Werley score there were 1 excellent (3.5%), 11 good (39.5%), 11 fair (39.5%) and 5 poor (17.5%) results. Degenerative changes of the distal radioulnar joint were associated with fair and poor results, and ulnar shortening osteotomy is only recommended in ulnocarpal impaction with an intact distal radioulnar joint. Osteotomy fixation with 3.5 mm dynamic compression plates enabled immediate postoperative mobilisation and resulted in a low complication rate. There was no advantage for the technically more demanding oblique as compared with a transverse osteotomy.
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Bowers WH (1993) The distal radioulnar joint. In: Green DP (ed) Operative hand surgery, 3rd edn. Churchill Livingstone, New York, pp 973–1019
Chun S, Palmer AK (1993) The ulnar impaction syndrome: follow-up of ulnar shortening osteotomy. J Hand Surg [Am] 18:46–53
Condamine JL, Lebreton L, Aubriot JH (1992) L'intervention de Sauve-Kapandji — analyse et résultats de 69 cas. Ann Chir Main 11:27–39
Darrow JC, Linscheid RL, Dobyns JH, Mann JM III, Wood MB, Beckenbaugh RD (1985) Distal ulnar recession for disorders of the distal radioulnar joint. J Hand Surg [Am] 10:482–491
Fernandez DL (1988) Radial osteotomy and Bowers arthroplasty for malunited fractures of the distal end of the radius. J Bone Joint Surg [Am] 70:1538–1551
Fernandez DL, Geissler WB (1989) Korrektureingriffe bei Fehlstellungen am distalen Radius. Z Unfallchir Versicherungsmed Berufskr 82:34–44
Field J, Majkowski RJ, Leslie IJ (1993) Poor results of Darrach's procedure after wrist injuries. J Bone Joint Surg [Br] 75:53–57
Friedmann SL, Palmer AK (1991) The ulnar impaction syndrome. Hand Clin 7:295–310
Matter P, Schütz M, Bühler M, Ungersböck A, Perren S (1994) Klinische Ergebnisse mit der Limited Contact DCP-Platte aus Titan — eine prospektive Studie mit 504 Fallen. Z Unfallchir Versicherungsmed 87:6–13
Milch H (1941) Cuff resection of the ulna for malunited Colles' fracture. J Bone Joint Surg 23:311–313
Minami A, Ogino T, Minami M (1987) Treatment of distal radioulnar disorders. J Hand Surg [Am] 12:189–196
Möllenhoff G, Walz M, Muhr G, Rehn J (1991) Posttraumatische Korrekturosteotomien am distalen Unterarm. Unfallchirurg 94:514–519
Oskam J, Kingma J, Klasen HJ (1993) Ulnar-shortening osteotomy after fracture of the distal radius. Arch Orthop Trauma Surg 112:198–200
Pfeiffer KM, Brennwald J, Büchler U, Hanel D, Jupiter J, Lowka K, Mark J, Staehlin P (1994) Implants of pure titanium for internal fixation of the peripheral skeleton. Injury 25:87–89
Rayhack JM, Gasser SI, Latta LL, Quellette EA, Milne EL (1993) Precision oblique osteotomy for shortening of the ulna. J Hand Surg [Am] 18:908–918
Roysam GS (1993) The distal radio-ulnar joint in Colles' fractures. J Bone Joint Surg [Br] 75:58–60
Steyers CM, Blair WF (1989) Measuring ulnar variance: a comparison of techniques. J Hand Surg [Am] 14:607–612
Voche P, Van Overstraeten L, Merle M (1993) Correction des désordres post-traumatique de Farticulation radioulnaire distale par intervention de Sauve-Kapandji. Rev Chir Orthop 79:464–472
Williams CS, Jupiter JB (1993) Das schmerzhafte Ulnokarpalgelenk. Orthopäde 22:36–45
Wright TW, Del Charco M, Wheeler D (1994) Incidence of ligament lesions and associated degenerative changes in the elderly wrist. J Hand Surg [Am] 19:313–318
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Fricker, R., Pfeiffer, K.M. & Troeger, H. Mar shortening osteotomy in posttraumatic ulnar impaction syndrome. Arch Orthop Trauma Surg 115, 158–161 (1996). https://doi.org/10.1007/BF00434545
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DOI: https://doi.org/10.1007/BF00434545