Long-Term Subjective Satisfaction after Ulna Shortening Osteotomy for Ulnar Impaction Syndrome

Abstract Background Ulnar shortening osteotomy (USO) is an effective treatment for ulnar impaction syndrome. However, there have been reports of osteoarthritis (OA) at the distal radioulnar joint (DRUJ) when USO was performed on patients with a reverse oblique sigmoid notch. This study aimed to evaluate the radiographic and functional outcomes following USO in patients with a reverse oblique sigmoid notch. Methods We retrospectively reviewed patients having a reverse oblique sigmoid notch who underwent USO for ulnar impaction syndrome between 2002 and 2013. We evaluated radiographic changes of the DRUJ and functional outcomes of patients. Results We enrolled 22 patients (22 wrists) with an average age of 49.6 years and a mean follow-up of 93.2 (range, 36–179; standard deviation [SD], 38.2) months. We found that there were changes in the inclination angle of the sigmoid notch, from an average reverse oblique of 14.9o (range, 11o–23o; SD, 3.4o) preoperatively to a more parallel 5.1o (range, 0o–11o; SD, 3.2o) at the final follow-up. The functional results at the final follow-up were good, with a mean visual analogue scale for pain of 0.2 (range, 0–1; SD, 0.4) at rest and 1.3 (range, 0–3; SD, 0.9) during activity, QuickDASH of 15.1 (range, 2.3–34.1; SD, 8.8), and modified Mayo Wrist Score of 91.6 (range, 70–100; SD, 6.4). Seven wrists (31.8%) had changes compatible with OA, but the wrists did not exhibit a significantly worse function when compared to wrists without OA changes, except for supination motion and grip strength. Conclusions For patients with a reverse oblique sigmoid inclination following USO, we observed that the inclination angle had a tendency to become parallel and some patients developed OA at the DRUJ. However, long-term functional outcomes could still be good. The reverse oblique sigmoid inclination does not seem to be an absolute contraindication for USO.

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Operative treatment of ulnar impaction syndrome: a systematic review

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193414541749 ◽

2014 ◽

Vol 40 (5) ◽

pp. 470-476 ◽

Cited By ~ 17

Author(s):

D. J. Stockton ◽

M.-E. Pelletier ◽

J. M. Pike

Keyword(s):

Future Research ◽

Scoring Methods ◽

Ovid Medline ◽

Ulnar Impaction ◽

Shortening Osteotomy ◽

Ulnar Impaction Syndrome ◽

Surgical Treatments ◽

Satisfaction Rates ◽

Participant Outcomes ◽

Ulna Shortening Osteotomy

This article critically and systematically reviews the surgical treatments for ulnar impaction syndrome. Three types of treatments currently exist: arthroscopic wafer procedure, open wafer procedure, and ulna shortening osteotomy. A total of 36 articles were included from searching the electronic databases PubMed MEDLINE, Ovid MEDLINE, and Ovid EMBASE. Studies were evaluated for quality using the Modified Detsky Score. Of these, 14 articles had a Modified Detsky Score of 6/10 or higher. Satisfaction rates were 100% for arthroscopic wafer procedure, 89% for open wafer procedure, and 84% for ulna shortening osteotomy. The percentage of participants reporting an excellent or good outcome was 82% for arthroscopic wafer procedure, 87% for open wafer procedure, and 76% for ulna shortening osteotomy. In conclusion, available evidence shows that arthroscopic wafer procedure and open wafer procedure may be viable alternatives to the more popular ulna shortening osteotomy, but clinical superiority is yet to be established. Future research should focus on prospective cohort methods and should report participant outcomes using validated scoring methods.

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Long-term radiographic outcomes and functional evaluation of ulnar shortening osteotomy in patients with ulnar impaction syndrome and reverse oblique sigmoid notch: a retrospective case series study

10.21203/rs.3.rs-23876/v3 ◽

2020 ◽

Author(s):

Hui-Kuang Huang ◽

Steve K. Lee ◽

Yi-Chao Huang ◽

Cheng-Yu Yin ◽

Ming-Chau Chang ◽

...

Keyword(s):

Inclination Angle ◽

Functional Outcomes ◽

Functional Evaluation ◽

Sigmoid Notch ◽

Ulnar Shortening Osteotomy ◽

Case Series Study ◽

Ulnar Impaction ◽

Shortening Osteotomy ◽

Ulnar Impaction Syndrome

Abstract Background: Ulnar shortening osteotomy (USO) is an effective treatment for ulnar impaction syndrome. However, there has been a concern of osteoarthritis (OA) developing at the distal radioulnar joint (DRUJ) if USO is performed on patients with a reverse oblique sigmoid notch. This study aimed to evaluate the radiographic and functional outcomes following USO in patients with a reverse oblique sigmoid notch.Methods: We retrospectively reviewed our patients with a reverse oblique sigmoid notch who underwent USO to treat ulnar impaction syndrome between 2002 and 2013. We evaluated the radiographic changes of the DRUJ and the patients’ functional outcomes.Results: We enrolled 22 patients (22 wrists) with an average age at operation of 49.6 years and mean follow-up of 93.2 (range, 36 - 179; SD 38.2) months. We found that there were changes in the inclination angle of the sigmoid notch, from an average of reverse oblique 14.9o (range, 11o - 23o; SD 3.4o) preoperatively to a more parallel 5.1o (range, 0o - 11o; SD 3.2o) at the final follow-ups. The functional results at the final follow-ups were good with a mean VAS for pain of 0.2 (range, 0 - 1; SD 0.4) at rest and 1.3 (range, 0 - 3; SD 0.9) during activity, QuickDASH of 15.1 (range, 2.3 - 34.1; SD 8.8), and modified Mayo Wrist Score of 91.6 (range, 70-100; SD 6.4). Seven wrists (31.8%) were noted to have OA changes, but the wrists did not exhibit a significantly worse function when compared to wrists without OA changes, except for supination motion and grip strength.Conclusions: For those patients with a reverse oblique sigmoid inclination following USO, the inclination angle would have a tendency to become more parallel and some patients would develop OA changes at the DRUJ, but the functional outcomes could still be good in the long term. The reverse oblique sigmoid inclination seems not to be an absolute contraindication for USO.

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Intermediate and long-term radiographic and functional outcomes of ulnar shortening osteotomy in patients with ulnar impaction syndrome and reverse oblique sigmoid notch

10.21203/rs.3.rs-23876/v1 ◽

2020 ◽

Author(s):

Hui-Kuang Huang ◽

Steve K. Lee ◽

Yi-Chao Huang ◽

Cheng-Yu Yin ◽

Ming-Chau Chang ◽

...

Keyword(s):

Inclination Angle ◽

Functional Outcomes ◽

Functional Results ◽

Osteoarthritic Change ◽

Sigmoid Notch ◽

Ulnar Shortening Osteotomy ◽

Ulnar Impaction ◽

Shortening Osteotomy ◽

Ulnar Impaction Syndrome

Abstract Background: Ulnar shortening osteotomy (USO) is an effective treatment for the ulnar impaction syndrome. But there has been a concern of osteoarthritis developing in the distal radioulnar joint (DRUJ) if we perform the USO in patients with reverse oblique sigmoid notch. This study was to evaluate the radiographic and functional outcomes following USO in patients with reverse oblique sigmoid notch.Methods: Between 2002 and 2013, we retrospectively reviewed our patients with reverse oblique sigmoid notch underwent USO in treating the ulnar impaction syndrome. We evaluated the radiographic changes in the DRUJ and their functional outcomes.Results: We enrolled 22 patients (22 wrists) with an average age at operation of 49.6 years and mean follow-up of 93.2 months. We found that there were changes in the inclination angle of sigmoid notch, from an average of reverse oblique 14.9o preoperatively to a more parallel of 5.1o at the final follow-ups. The functional results at the final follow-ups were good with the mean VAS for pain of 0.3 at rest and 1.4 during activity, QuickDASH of 16.5, and modified Mayo Wrist Score of 91.4. There were 7 wrists (31.8%) noted to have osteoarthritic change, but they did not exhibit significantly worse function, except supination motion, pain during activity, and grip strength.Conclusions For the patients with reverse oblique sigmoid inclination following USO, the inclination angle would have a tendency to become more parallel and some would develop the osteoarthritic change in the DRUJ, but the functional outcomes could still be good in the intermediate and long-term. The reverse oblique sigmoid inclination seems not to be an absolute contraindication for USO.

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Long-term radiographic outcomes and functional evaluation of ulnar shortening osteotomy in patients with ulnar impaction syndrome and reverse oblique sigmoid notch: a retrospective case series study

10.21203/rs.3.rs-23876/v5 ◽

2021 ◽

Author(s):

Hui-Kuang Huang ◽

Steve K. Lee ◽

Yi-Chao Huang ◽

Cheng-Yu Yin ◽

Ming-Chau Chang ◽

...

Keyword(s):

Inclination Angle ◽

Functional Outcomes ◽

Functional Evaluation ◽

Sigmoid Notch ◽

Ulnar Shortening Osteotomy ◽

Ulnar Impaction ◽

Shortening Osteotomy ◽

Ulnar Impaction Syndrome

Abstract Background: Ulnar shortening osteotomy (USO) is an effective treatment for ulnar impaction syndrome. However, there have been reports of osteoarthritis (OA) at the distal radioulnar joint (DRUJ) when USO was performed on patients with a reverse oblique sigmoid notch. This study aimed to evaluate the radiographic and functional outcomes following USO in patients with a reverse oblique sigmoid notch.Methods: We retrospectively reviewed patients having a reverse oblique sigmoid notch who underwent USO for ulnar impaction syndrome between 2002 and 2013. We evaluated radiographic changes of the DRUJ and functional outcomes of patients.Results: We enrolled 22 patients (22 wrists) with an average age of 49.6 years and a mean follow-up of 93.2 (range, 36–179; standard deviation [SD], 38.2) months. We found that there were changes in the inclination angle of the sigmoid notch, from an average reverse oblique of 14.9o (range, 11o–23o; SD, 3.4o) preoperatively to a more parallel 5.1o (range, 0o–11o; SD, 3.2o) at the final follow-up. The functional results at the final follow-up were good, with a mean visual analogue scale for pain of 0.2 (range, 0–1; SD, 0.4) at rest and 1.3 (range, 0–3; SD, 0.9) during activity, QuickDASH of 15.1 (range, 2.3–34.1; SD, 8.8), and modified Mayo Wrist Score of 91.6 (range, 70–100; SD, 6.4). Seven wrists (31.8%) had changes compatible with OA, but the wrists did not exhibit a significantly worse function when compared to wrists without OA changes, except for supination motion and grip strength.Conclusions: For patients with a reverse oblique sigmoid inclination following USO, we observed that the inclination angle had a tendency to become parallel and some patients developed OA at the DRUJ. However, long-term functional outcomes could still be good. The reverse oblique sigmoid inclination does not seem to be an absolute contraindication for USO.

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Long-term radiographic outcomes and functional evaluation of ulnar shortening osteotomy in patients with ulnar impaction syndrome and reverse oblique sigmoid notch

10.21203/rs.3.rs-23876/v2 ◽

2020 ◽

Author(s):

Hui-Kuang Huang ◽

Steve K. Lee ◽

Yi-Chao Huang ◽

Cheng-Yu Yin ◽

Ming-Chau Chang ◽

...

Keyword(s):

Inclination Angle ◽

Functional Outcomes ◽

Functional Results ◽

Functional Evaluation ◽

Sigmoid Notch ◽

Ulnar Shortening Osteotomy ◽

Ulnar Impaction ◽

Shortening Osteotomy ◽

Ulnar Impaction Syndrome

Abstract Background: Ulnar shortening osteotomy (USO) is an effective treatment for ulnar impaction syndrome. However, there has been a concern of osteoarthritis (OA) developing at the distal radioulnar joint (DRUJ) if USO is performed on patients with a reverse oblique sigmoid notch. This study aimed to evaluate the radiographic and functional outcomes following USO in patients with a reverse oblique sigmoid notch.Methods: We retrospectively reviewed our patients with a reverse oblique sigmoid notch who underwent USO to treat ulnar impaction syndrome between 2002 and 2013. We evaluated the radiographic changes of the DRUJ and the patients’ functional outcomes.Results: We enrolled 22 patients (22 wrists) with an average age at operation of 49.6 years and mean follow-up of 93.2 (range, 36 - 179; SD 38.2) months. We found that there were changes in the inclination angle of the sigmoid notch, from an average of reverse oblique 14.9o (range, 11o - 23o; SD 3.4o) preoperatively to a more parallel 5.1o (range, 0o - 11o; SD 3.2o) at the final follow-ups. The functional results at the final follow-ups were good with a mean VAS for pain of 0.2 (range, 0 - 1; SD 0.4) at rest and 1.3 (range, 0 - 3; SD 0.9) during activity, QuickDASH of 15.1 (range, 2.3 - 34.1; SD 8.8), and modified Mayo Wrist Score of 91.6 (range, 70-100; SD 6.4). Seven wrists (31.8%) were noted to have OA changes, but the wrists did not exhibit a significantly worse function when compared to wrists without OA changes, except for supination motion and grip strength.Conclusions: For those patients with a reverse oblique sigmoid inclination following USO, the inclination angle would have a tendency to become more parallel and some patients would develop OA changes at the DRUJ, but the functional outcomes could still be good in the long term. The reverse oblique sigmoid inclination seems not to be an absolute contraindication for USO.

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