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J Wrist Surg 2017; 06(01): 039-045
DOI: 10.1055/s-0036-1585069
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Oblique Metaphyseal Shortening Osteotomy of the Distal Ulna: Surgical Technique and Results of Ten Patients

Szabolcs Benis
1   Department of Orthopaedics and Traumatology, Upper Limb Unit, Orthoclinic Brugge, Bruges, Belgium
2   Department of Orthopaedics and Traumatology, University Hospital Ghent, Ghent, Belgium
,
Jean F. Goubau
1   Department of Orthopaedics and Traumatology, Upper Limb Unit, Orthoclinic Brugge, Bruges, Belgium
3   Department of Orthopaedics and Traumatology, University Hospital Brussels (VUB-Vrije Universiteit Brussel), Jette, Belgium
,
Koen Mermuys
4   Department of Radiology, AZ Sint-Jan AV Brugge-Oostende, Campus Brugge, Bruges, Belgium
,
Petrus Van Hoonacker
1   Department of Orthopaedics and Traumatology, Upper Limb Unit, Orthoclinic Brugge, Bruges, Belgium
,
Bart Berghs
1   Department of Orthopaedics and Traumatology, Upper Limb Unit, Orthoclinic Brugge, Bruges, Belgium
,
Diederick Kerckhove
1   Department of Orthopaedics and Traumatology, Upper Limb Unit, Orthoclinic Brugge, Bruges, Belgium
,
Bert Vanmierlo
1   Department of Orthopaedics and Traumatology, Upper Limb Unit, Orthoclinic Brugge, Bruges, Belgium
› Author Affiliations
Further Information

Publication History

23 February 2016

30 May 2016

Publication Date:
01 August 2016 (online)

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Abstract

Background Ulnocarpal abutment is a common condition following distal radius fractures. There are different surgical methods of treatment for this pathology: open and arthroscopic wafer procedure or an ulnar shortening osteotomy. We describe an oblique metaphyseal shortening osteotomy of the distal ulna using two cannulated headless compression screws. We report the results of 10 patients treated with this method.

Materials and Methods Out of 17 patients, 10 could be reviewed retrospectively for this study. Patient-rated outcomes were measured using the VAS (visual analogue scale) for pain, PRWHE (patient-rated wrist and hand evaluation) survey, and Quick-DASH (disability of arm, shoulder and hand) survey for functional outcomes. At the review we measured the range of motion (ROM) of the wrist (extension and flexion, ulnar and radial deviation, pronation and supination). Grip strength, pronation, and supination strength of the forearm was measured using a calibrated hydraulic dynamometer. ROM and strength of the affected wrist was compared with ROM and strength of the unaffected wrist.

Surgical Procedure Oblique long metaphyseal osteotomy of the distal ulna (from proximal-ulnar to distal-radial), fixed with two cannulated headless compression screws.

Results The average postoperative VAS score for pain was 23.71 (standard deviation [SD] of 30.41). The average postoperative PRWHE score was 32.55 (SD of 26.28). The average postoperative Quick-DASH score was 28.65 (SD of 27.21). The majority of patients had a comparable ROM and strength between the operated side and the non-operated side.

Conclusion This surgical technique has the advantage of reducing the amount of hardware and to decrease the potential hinder caused by it on medium term. Moreover, the incision remains smaller, and the anatomic metaphyseal localization of the osteotomy potentially allows a better and rapid healing.

Keywords

ulnocarpal abutment - ulnar shortening - oblique metaphyseal osteotomy - headless compression screw

Note

This study received the approval of the Leading Ethics Committee number 1755 of the AZ Sint–Jan AV Brugge–Oostende, campus Brugge, Brugge, Belgium.


 

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