Literature DB >> 28391754

Time-Dependent Recovery of Outcome Parameters in Ulnar Shortening for Positive Ulnar Variance: A Prospective Case Series.

Gernot Schmidle1, Tobias Kastenberger1, Rohit Arora1.   

Abstract

BACKGROUND: This study evaluates the results of ulnar shortening using the ulna osteotomy locking plate system (UOL; I.T.S. GmbH, Graz, Austria) with special regard to the time-dependent recovery of subjective and objective outcome parameters and surgeons' experiences.
METHODS: Ulnar shortening using the UOL was performed on 11 patients (3 men, 8 women) with an average age of 47 ± 19.6 years. Range of motion (ROM) and grip strength were compared with the contralateral hand. Patient-rated outcomes were measured using a visual analogue scale (VAS) for pain and the Disability of the Arm, Shoulder and Hand (DASH) and the Patient Rated Wrist Evaluation (PRWE) survey for subjective outcomes. Ulnar variance and bony union were assessed using conventional wrist radiographs. The surgeons evaluated intraoperative handling through a standardized feedback form.
RESULTS: ROM improved and grip strength increased significantly between preoperative values and final follow-up. Flexion and supination improved significantly between weeks 8 and 12 and grip strength from week 8 onward. Patient-rated outcomes changed significantly with a final DASH score of 14.2 ± 12.4 and a PRWE score of 24.3 ± 17.0. Pain levels improved significantly with no pain at rest and a mean VAS of 0.8 ± 1.2 during activity. The average amount of shortening was 4.0 ± 1.9 mm with a final ulnar variance of 0.2 ± 1.8 mm. All osteotomies healed with 2 cases of delayed union.
CONCLUSIONS: In ulnar shortening with the UOL, wrist function recovered after an initial decrease from week 8 onward. Subjective outcome parameters showed early recovery and improved continuously over time.

Entities:  

Keywords:  positive ulnar variance; recovery; time dependent; ulna leveling; ulna osteotomy locking plate; ulnar impaction syndrome; ulnar shortening osteotomy; wrist pain

Mesh:

Year:  2017        PMID: 28391754      PMCID: PMC5950970          DOI: 10.1177/1558944717702465

Source DB:  PubMed          Journal:  Hand (N Y)        ISSN: 1558-9447


  26 in total

1.  Combined arthroscopic TFCC debridement and wafer resection of the distal ulna in wrists with triangular fibrocartilage complex tears and positive ulnar variance.

Authors:  M M Tomaino; R W Weiser
Journal:  J Hand Surg Am       Date:  2001-11       Impact factor: 2.230

2.  Initial shortening and internal fixation in combination with a Sauvé-Kapandji procedure for severely comminuted fractures of the distal radius in elderly patients.

Authors:  R Arora; M Gabl; S Pechlaner; M Lutz
Journal:  J Bone Joint Surg Br       Date:  2010-11

3.  Wafer distal ulna resection for triangular fibrocartilage tears and/or ulna impaction syndrome.

Authors:  P Feldon; A L Terrono; M R Belsky
Journal:  J Hand Surg Am       Date:  1992-07       Impact factor: 2.230

4.  Ulnar shortening osteotomy with a premounted sliding-hole plate.

Authors:  Hugo B Kitzinger; Birgit Karle; Steffen Löw; Hermann Krimmer
Journal:  Ann Plast Surg       Date:  2007-06       Impact factor: 1.539

5.  Comparison of ulnar-shortening osteotomy with a new Trimed dynamic compression system versus the Synthes dynamic compression system: clinical study.

Authors:  Shai Luria; Anthony J Lauder; Thomas E Trumble
Journal:  J Hand Surg Am       Date:  2008-11       Impact factor: 2.230

6.  A cadaveric study of the anatomy and stability of the distal radioulnar joint in the coronal and transverse planes.

Authors:  A R Tolat; J K Stanley; I A Trail
Journal:  J Hand Surg Br       Date:  1996-10

7.  Ulnar shortening osteotomy for ulnar-sided wrist pain.

Authors:  Masahiro Tatebe; Takanobu Nishizuka; Hitoshi Hirata; Ryogo Nakamura
Journal:  J Wrist Surg       Date:  2014-05

8.  Ulnar shortening with the ulna osteotomy locking plate.

Authors:  G Schmidle; R Arora; M Gabl
Journal:  Oper Orthop Traumatol       Date:  2012-07       Impact factor: 1.154

9.  Outcome analysis of ulnar shortening osteotomy for ulnar impaction syndrome.

Authors:  Courtney Fulton; Ruby Grewal; Kenneth J Faber; James Roth; Bing Siang Gan
Journal:  Can J Plast Surg       Date:  2012

10.  Clinical, radiographic, and arthroscopic outcomes after ulnar shortening osteotomy: a long-term follow-up study.

Authors:  Masahiro Tatebe; Takaaki Shinohara; Nobuyuki Okui; Michiro Yamamoto; Hitoshi Hirata; Toshihiko Imaeda
Journal:  J Hand Surg Am       Date:  2012-12       Impact factor: 2.230

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  4 in total

Review 1.  Solitary ulnar shortening osteotomy for malunion of distal radius fractures: experience of a centre in the UK and review of the literature.

Authors:  S Hassan; R Shafafy; A Mohan; P Magnussen
Journal:  Ann R Coll Surg Engl       Date:  2019-01-30       Impact factor: 1.891

2.  The Effect of Early Active Mobilization on Union Rate after Ulnar Shortening Osteotomy.

Authors:  Julia Blackburn; Rukhtam Saqib; Jemma Rooker; Andreas Baumann; Rouin Amirfeyz
Journal:  J Wrist Surg       Date:  2018-10-31

3.  What is the Natural History of the Triangular Fibrocartilage Complex Tear Without Distal Radioulnar Joint Instability?

Authors:  Joon Kyu Lee; Jae-Yeon Hwang; Suk Yoon Lee; Bong Cheol Kwon
Journal:  Clin Orthop Relat Res       Date:  2019-02       Impact factor: 4.176

4.  Outcomes of ulna shortening osteotomy: a cohort analysis of 106 patients.

Authors:  J S Teunissen; R M Wouters; S Al Shaer; O T Zöphel; G M Vermeulen; S E R Hovius; E P A Van der Heijden
Journal:  J Orthop Traumatol       Date:  2022-01-05
  4 in total

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