Abstract
Background
Successful short-term results of diaphyseal ulna shortening osteotomy are documented in both idiopathic and post-traumatic ulnar impaction.
Questions/Purposes
The purpose of this study was to evaluate the mid-term outcomes of ulnar shortening osteotomy with respect to radiographic assessment of corrected alignment and healing as well as patient satisfaction, pain, and function assessed using the Disability of the Arm, Shoulder, and Hand (DASH) score.
Patients and Methods
This retrospective case series included follow-up of 33 patients with ulnar impaction syndrome following ulna shortening osteotomy at a minimum of 5 years. Patient-rated outcomes included satisfaction, pain assessment, and DASH score. Pre- and postoperative radiographs were reviewed to quantify ulnar variance and osteotomy union rates. Subsequent operations were also recorded.
Results
Average follow-up was 10 years (range, 5–20 years). Eighty-eight percent of patients reported they were either satisfied or very satisfied with the procedure and 91% reported they would have the same procedure again. Average pain rating was 2 out of 10 at final follow-up. The mean DASH score was 11 (range, 0–39). Removal of hardware was performed in 10 patients (30%). The overall rate of reoperation was 45%.
Conclusions
Ulna shortening osteotomy yields reliable midterm satisfaction and pain relief in patients with idiopathic and post-traumatic ulnar impaction syndrome. Reoperation is frequent. Consistent with results of short-term follow-up, plate irritation requiring removal remains the most common cause for reoperation over time.
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Disclosures
Conflict of Interest:
Duretti T. Fufa, MD, Ryan P. Calfee, MD, Nandita Sriram, BS, Andrew J. Weiland, MD have declared that they have no conflict of interest. Richard H. Gelberman, MD is a board member of JBJS Board of Trustees and Healthpoint Capital and receives royalties from Wolters-Kluwer and Medartis, outside the work. Michele G. Carlson, MD is a board member of ASSH, received a RJOS Research Grant, payments for manuscript preparation from Hand Clinics Editor 2012, patent pending on a retractor, and payments for travel expenses for meetings from HSS and ASSH, outside the work.
Human/Animal Rights:
All procedures followed were in accordance with the ethical standards of the Responsible Committee on Human Experimentation (institutional and national) and with the Helsinki Declaration of 1975 as revised in 2008 (5).
Informed Consent:
Informed consent was obtained from all patients for being included in the study.
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Level of Evidence: Therapeutic Level IV, case series.
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Fufa, D.T., Carlson, M.G., Calfee, R.P. et al. Mid-Term Results Following Ulna Shortening Osteotomy. HSS Jrnl 10, 13–17 (2014). https://doi.org/10.1007/s11420-013-9371-7
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DOI: https://doi.org/10.1007/s11420-013-9371-7