Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2016 Jan;137(1):175-184.
doi: 10.1097/PRS.0000000000001870.

Ulna-Shortening Osteotomy: Outcome and Repercussion of the Distal Radioulnar Joint Osteoarthritis

Antoine de Runz  1 , Nicolas Pauchard, Thomas Sorin, François Dap, Gilles Dautel
Affiliations
Comparative Study

Ulna-Shortening Osteotomy: Outcome and Repercussion of the Distal Radioulnar Joint Osteoarthritis

Antoine de Runz et al. Plast Reconstr Surg. 2016 Jan.

Abstract

Background: Ulnocarpal impaction syndrome occurs mostly in patients with positive ulnar variance. Ulnar-shortening osteotomy is a commonly used method to correct it, but degenerative changes may appear in the distal radioulnar joint. The authors evaluated outcome after ulnar-shortening osteotomy, particularly the impact of distal radioulnar joint osteoarthritis.

Methods: A 10-year study was performed of patients who underwent ulnar-shortening osteotomy.

Results: Forty-six patients were available for clinical examination and radiography. Twenty-nine wrists showed worsening or new osteoarthritis. A difference of preulnar variance and resection was noted: 4.64 mm and 4.48 mm, respectively, in the osteoarthritis group versus 3.50 mm and 3.38 mm in the group without osteoarthitis. Comparison of patients with osteoarthritis revealed a significant limitation of range of motion in flexion-extension (p = 0.009) and pronosupination (p = 0.028): 102 degrees and 138 degrees, respectively, in the osteroarthritis group versus 124 degrees and 155 degreees in the group without osterarthritis. The type of distal radioulnar joint differed significantly (p = 0.038), with a predominance of type I in the osterarthritis group and type II in the group without osterarthritis. Functional outcome was significantly worse in the osterarthritis group versus the group without osteoarthritis concerning the Patient-Rated Wrist Evaluation score (39.07 versus 22.59, p = 0.031), the Quick Disabilities of the Arm, Shoulder, and Hand score (27.38 versus 19.59, p = 0.017), and the modified Gartland-Werley score (76.72 versus 85.14, p = 0.027).

Conclusions: Ulnar-shortening osteotomy modifies the congruence of the distal radioulnar joint, and the type I joint may be at increased risk of arthrosis. Osteoarthritis has a clinical impact, and the amount of ulnar shortening should be limited to what is needed to avoid altering the functional outcome.

Clinical question/level of evidence: Therapeutic, III.

PubMed Disclaimer

References

    1. Palmer AK, Werner FW. Biomechanics of the distal radioulnar joint. Clin Orthop. 1984;187:26–35
    1. Wright TW, Del Charco M, Wheeler D. Incidence of ligament lesions and associated degenerative changes in the elderly wrist. J Hand Surg Am. 1994;19:313–318
    1. Chun S, Palmer AK. The ulnar impaction syndrome: Follow-up of ulnar shortening osteotomy. J Hand Surg Am. 1993;18:46–53
    1. Friedman SL, Palmer AK. The ulnar impaction syndrome. Hand Clin. 1991;7:295–310
    1. Baek GH, Lee HJ, Gong HS, et al. Long-term outcomes of ulnar shortening osteotomy for idiopathic ulnar impaction syndrome: At least 5-years follow-up. Clin Orthop Surg. 2011;3:295–301

Publication types

MeSH terms