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

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: a retrospective case series study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04029-7 ◽

2021 ◽

Vol 22 (1) ◽

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: 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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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

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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/v4 ◽

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, we observed that 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 Outcomes of Ulnar Shortening Osteotomy for Idiopathic Ulnar Impaction Syndrome: At Least 5-Years Follow-up

Clinics in Orthopedic Surgery ◽

10.4055/cios.2011.3.4.295 ◽

2011 ◽

Vol 3 (4) ◽

pp. 295 ◽

Cited By ~ 33

Author(s):

Goo Hyun Baek ◽

Hyuk Jin Lee ◽

Hyun Sik Gong ◽

Seung Hwan Rhee ◽

Jihyeung Kim ◽

...

Keyword(s):

Long Term Outcomes ◽

Ulnar Shortening Osteotomy ◽

Ulnar Impaction ◽

Shortening Osteotomy ◽

Ulnar Impaction Syndrome

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Long-Term Outcome of Step-Cut Ulnar-Shortening Osteotomy for Ulnar Impaction Syndrome

Hand ◽

10.1177/1558944716660555ho ◽

2016 ◽

Vol 11 (1_suppl) ◽

pp. 114S-114S

Author(s):

Loukia K. Papatheodorou ◽

Mark E. Baratz ◽

Dean G. Sotereanos

Keyword(s):

Term Outcome ◽

Long Term Outcome ◽

Ulnar Shortening Osteotomy ◽

Ulnar Impaction ◽

Shortening Osteotomy ◽

Ulnar Impaction Syndrome

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Stress distribution pattern in the distal radioulnar joint before and after ulnar shortening osteotomy in patients with ulnar impaction syndrome

10.21203/rs.3.rs-218904/v1 ◽

2021 ◽

Author(s):

Kazutoshi Hontani ◽

Yuichiro Matsui ◽

Daisuke Kawamura ◽

Atsushi Urita ◽

Daisuke Momma ◽

...

Keyword(s):

Stress Distribution ◽

Distribution Pattern ◽

Distal Radioulnar Joint ◽

Radioulnar Joint ◽

Sigmoid Notch ◽

Ulnar Shortening Osteotomy ◽

Ulnar Impaction ◽

Shortening Osteotomy ◽

Type C ◽

Ulnar Impaction Syndrome

Abstract Ulnar shortening osteotomy (USO) for ulnar impaction syndrome potentially leads to degenerative changes of the distal radioulnar joint (DRUJ). The aim of this study was to evaluate the effect of the sigmoid notch morphology on the stress distribution pattern of the DRUJ using computed tomography (CT) osteoabsorptiometry (CT-OAM). We reviewed the pre- and postoperative transverse CT images of 15 wrists that had undergone USO. The examined wrists were classified into two groups based on the sigmoid notch morphology: the linear-type notch (type L) and the curved-type notch (type C). We calculated and statistically compared the percentage of the high-density area (%HDA) in each divided region of the sigmoid notch. In type L, %HDA was significantly larger in the distal-dorsal region of the sigmoid notch before USO. Postoperatively, in type L, no specific regions showed significantly different %HDA. In type C, %HDA was significantly larger in the distal-volar region of the sigmoid notch before USO. Postoperatively, %HDA of type C was significantly larger in the proximal-volar region. Our results suggest that in patients with USO, morphological evaluation of the sigmoid notch can serve as a predictor of osteoarthritis in the DRUJ with or without USO.

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