A Terzis1, F Neubrech2, J Sebald2, M Sauerbier2. 1. Abteilung für Plastische, Hand- und Rekonstruktive Chirurgie, BG Unfallklinik Frankfurt am Main, Akademisches Lehrkrankenhaus, Goethe-Universität Frankfurt am Main, Friedberger Landestr. 430, 60389, Frankfurt am Main, Deutschland. athanasios.terzis@bgu-frankfurt.de. 2. Abteilung für Plastische, Hand- und Rekonstruktive Chirurgie, BG Unfallklinik Frankfurt am Main, Akademisches Lehrkrankenhaus, Goethe-Universität Frankfurt am Main, Friedberger Landestr. 430, 60389, Frankfurt am Main, Deutschland.
Abstract
OBJECTIVE: Extra-articular shortening of the distal ulna in order to decompress the ulnocarpal joint. INDICATIONS: Congenital or posttraumatic, symptomatic ulnar impaction syndrome. CONTRAINDICATIONS: Osteoarthritis or deformation of the distal radioulnar joint. SURGICAL TECHNIQUE: Exactly defined oblique osteotomy in the distal third of the ulna using the saw guide, closing of the osteotomy gap using the compression spindle, osteosynthesis with the locking plate. POSTOPERATIVE MANAGEMENT: Palmar forearm thermoplastic cast or splint for 3 weeks, load bearing after bony union. RESULTS: Between June 2016 and March 2018 ulnar shortening was performed in 17 patients using the new locking plate. In all, 15 patients were reevaluated with complete follow-up data. Postoperatively patients experienced significant pain reduction (Visual Analog Scale 0-10) by 65% (7 before and 2.5 after surgery; p < 0.05) and a significant improvement of function (Disabilities of Arm, Shoulder and Hand 0-100) by 49% (47 before and 24 after surgery; p < 0.05). Bony union was observed in all patients after a mean time of 4 months. Overall patient satisfaction was high.
OBJECTIVE: Extra-articular shortening of the distal ulna in order to decompress the ulnocarpal joint. INDICATIONS: Congenital or posttraumatic, symptomatic ulnar impaction syndrome. CONTRAINDICATIONS: Osteoarthritis or deformation of the distal radioulnar joint. SURGICAL TECHNIQUE: Exactly defined oblique osteotomy in the distal third of the ulna using the saw guide, closing of the osteotomy gap using the compression spindle, osteosynthesis with the locking plate. POSTOPERATIVE MANAGEMENT: Palmar forearm thermoplastic cast or splint for 3 weeks, load bearing after bony union. RESULTS: Between June 2016 and March 2018 ulnar shortening was performed in 17 patients using the new locking plate. In all, 15 patients were reevaluated with complete follow-up data. Postoperatively patients experienced significant pain reduction (Visual Analog Scale 0-10) by 65% (7 before and 2.5 after surgery; p < 0.05) and a significant improvement of function (Disabilities of Arm, Shoulder and Hand 0-100) by 49% (47 before and 24 after surgery; p < 0.05). Bony union was observed in all patients after a mean time of 4 months. Overall patient satisfaction was high.
Authors: C K Spies; T Bruckner; L P Müller; F Unglaub; P Eysel; S Löw; M J Filbert Journal: Arch Orthop Trauma Surg Date: 2021-05-01 Impact factor: 3.067