Loukia K Papatheodorou1, Dean G Sotereanos1,2. 1. Orthopaedic Specialists-UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania. 2. University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Abstract
INTRODUCTION: The step-cut ulnar shortening osteotomy for the treatment of ulnar impaction syndrome is a safe, reliable, and less expensive technique that uses a 7-hole 3.5-mm standard neutralization plate and a lag screw for fixation, thus avoiding the need for the special instrumentation that other ulnar shortening techniques require. STEP 1 PREOPERATIVE PLANNING: Perform a physical examination and obtain imaging studies to identify all associated abnormalities. STEP 2 WRIST ARTHROSCOPY VIDEO 1: Verify the diagnosis of ulnar impaction syndrome and treat concurrent intra-articular abnormalities. STEP 3 INCISION FOR THE ULNAR SHORTENING OSTEOTOMY VIDEO 2: Make a longitudinal skin incision along the distal third of the ulna. STEP 4 DESIGN THE STEP-CUT ULNAR SHORTENING OSTEOTOMY VIDEO 2: Design the step-cut ulnar shortening osteotomy. STEP 5 PERFORM THE STEP-CUT ULNAR SHORTENING OSTEOTOMY VIDEO 2: Create the step-cut ulnar shortening osteotomy using an oscillating saw. STEP 6 FIXATION OF THE OSTEOTOMY VIDEO 3: Fix the osteotomy with a lag screw and volar plate. STEP 7 WOUND CLOSURE: Meticulously close the wound in layers. STEP 8 POSTOPERATIVE CARE: Protect the affected arm for the first 6 weeks. RESULTS: In our original study, 164 patients with symptomatic ulnar impaction syndrome were treated with a step-cut ulnar shortening osteotomy using a volar 3.5-mm standard neutralization plate and a lag screw14.
INTRODUCTION: The step-cut ulnar shortening osteotomy for the treatment of ulnar impaction syndrome is a safe, reliable, and less expensive technique that uses a 7-hole 3.5-mm standard neutralization plate and a lag screw for fixation, thus avoiding the need for the special instrumentation that other ulnar shortening techniques require. STEP 1 PREOPERATIVE PLANNING: Perform a physical examination and obtain imaging studies to identify all associated abnormalities. STEP 2 WRIST ARTHROSCOPY VIDEO 1: Verify the diagnosis of ulnar impaction syndrome and treat concurrent intra-articular abnormalities. STEP 3 INCISION FOR THE ULNAR SHORTENING OSTEOTOMY VIDEO 2: Make a longitudinal skin incision along the distal third of the ulna. STEP 4 DESIGN THE STEP-CUT ULNAR SHORTENING OSTEOTOMY VIDEO 2: Design the step-cut ulnar shortening osteotomy. STEP 5 PERFORM THE STEP-CUT ULNAR SHORTENING OSTEOTOMY VIDEO 2: Create the step-cut ulnar shortening osteotomy using an oscillating saw. STEP 6 FIXATION OF THE OSTEOTOMY VIDEO 3: Fix the osteotomy with a lag screw and volar plate. STEP 7 WOUND CLOSURE: Meticulously close the wound in layers. STEP 8 POSTOPERATIVE CARE: Protect the affected arm for the first 6 weeks. RESULTS: In our original study, 164 patients with symptomatic ulnar impaction syndrome were treated with a step-cut ulnar shortening osteotomy using a volar 3.5-mm standard neutralization plate and a lag screw14.
Authors: Philipp Honigmann; Maximilian Hofer; Sibylle Hirsch; Marta Morawska; Magdalena Müller-Gerbl; Florian M Thieringer; Enrico Coppo Journal: Int J Med Robot Date: 2022-07-08 Impact factor: 2.483