Comparative Study of Ulnar-Shortening Osteotomy, Arthroscopy Wafer Procedure, and Distal Metaphyseal Ulnar-Shortening Osteotomy for Ulnar Impaction Syndrome

Abstract

Purpose: To investigate the results of ulnar-shortening osteotomy, arthroscopy wafer procedure, and distal metaphyseal ulnar-shortening osteotomy for the treatment of ulnar impaction syndrome. Methods: In all, 33 cases of ulnar impaction syndrome, which were treated with ulna orthopedic surgery in our hospital from June 2011 to May 2014, were studied retrospectively. They were divided into 3 groups: group A, including 10 cases who underwent ulnar-shortening osteotomy; group B, including 19 cases who underwent arthroscopy wafer procedure; group C, including 4 cases who underwent distal metaphyseal ulnar-shortening osteotomy. Wrist functions of these cases were evaluated before the surgery and after the surgery every 3 months. The evaluations included visual analogue scale, range of motion, grip strength, and the modified Mayo wrist scores. Results: The mean follow-up period was 25 months (SD, ±14). In group A, 9 cases underwent pain relief, 1 better. In group B, 13 relief, 5 better, and 1 no improvement. In group C, 1 relief, 2 better, and 1 no improvement. Conclusions: Ulnar diaphyseal shortening osteotomy, arthroscopy wafer procedure, and distal metaphyseal ulnar-shortening osteotomy are effective surgical options of ulnar impaction syndrome. Ulnar-shortening osteotomy is reliable procedure in pain relief. The shape of the distal radioulnar joint in the midcoronal plane should be considered in the decision-making stage.