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. 2022 May;3(5):375-382.
doi: 10.1302/2633-1462.35.BJO-2022-0031.R1.

Long-term outcomes after ulna shortening osteotomy: a mean follow-up of six years

Joris S Teunissen  1   2 , Mark J W van der Oest  2   3   4 , Ruud W Selles  3   4 , Dietmar J O Ulrich  1 , Steven E R Hovius  1   2 , Brigitte van der Heijden  1   5 ; Hand Wrist Study Group contributors
Affiliations

Long-term outcomes after ulna shortening osteotomy: a mean follow-up of six years

Joris S Teunissen et al. Bone Jt Open. 2022 May.

Abstract

Aims: The primary aim of this study was to describe long-term patient-reported outcomes after ulna shortening osteotomy for ulna impaction syndrome.

Methods: Overall, 89 patients treated between July 2011 and November 2017 who had previously taken part in a routine outcome evaluation up to 12 months postoperatively were sent an additional questionnaire in February 2021. The primary outcome was the Patient-Rated Wrist and Hand Evaluation (PRWHE) total score. Secondary outcomes included patient satisfaction with treatment results, complications, and subsequent treatment for ulnar-sided wrist pain. Linear mixed models were used to compare preoperative, 12 months, and late follow-up (ranging from four to nine years) PRWHE scores.

Results: Long-term outcomes were available in 66 patients (74%) after a mean follow-up of six years (SD 1). The mean PRWHE total score improved from 63 before surgery to 19 at late follow-up (difference in means (Δ) 44; 95% confidence interval (CI) 39 to 50; p = <0.001). Between 12 months and late follow-up, the PRWHE total score also improved (Δ 12; 95% CI 6 to 18; p = < 0.001). At late follow-up, 14/66 of patients (21%) reported a PRWHE total score of zero, whereas this was 3/51 patients (6%) at 12 months (p = 0.039). In all, 58/66 patients (88%) would undergo the same treatment again under similar circumstances. Subsequent treatment (total n = 66; surgical n = 57) for complications or recurrent symptoms were performed in 50/66 patients (76%). The most prevalent type of reoperation was hardware removal in 42/66 (64%), and nonunion occurred in 8/66 (12%).

Conclusion: Ulna shortening osteotomy improves patient-reported pain and function that seems to sustain at late follow-up. While satisfaction levels are generally high, reoperations such as hardware removal are common. Cite this article: Bone Jt Open 2022;3(5):375-382.

Keywords: DRF; DRUJ; PROM; Revision surgery; Ulna; Ulna shortening osteotomy; Wrist; clinician; distal radioulnar joint; immobilization; nonunion; patient-reported outcome measures (PROMs); shortening osteotomy; ulnar impaction syndrome; ulnar sided wrist pain.

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Conflict of interest statement

ICMJE COI statement: The authors confirm that they have no conflicts to declare.

Figures

Fig. 1
Fig. 1
Longitudinal individual Patient-Rated Wrist and Hand Evaluation (PRWHE; range 0 to 100) total score before surgery and at 12 months and late follow-up (mean of six years) after surgery. Individual lines were code coloured between timepoints (intake to 12 months; 12 months to late follow-up; intake to late follow-up if the 12-month score was missing) based on their change score in relation to the minimal clinically important difference of 17 points.
See this image and copyright information in PMC

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