Abstract
Background Ulnar shortening osteotomy of the diaphysis is a common and effective surgical procedure
for ulnar abutment syndrome. However, this procedure has some disadvantages, such
as a long period until union and a relatively high nonunion rate. To overcome these
disadvantages, we have developed distal ulnar metaphyseal wedge osteotomy. The purpose
of this article is to describe the technique and to report its clinical results.
Patients and Methods Distal ulnar metaphyseal wedge osteotomy consists of resection of the wedge fragment
at the distal ulnar metaphysis, compressing the distal fragment of the ulna toward
the radial–proximal direction and fixation with a Herbert type headless screw. We
performed this procedure for 58 patients with ulnar abutment syndrome, and the clinical
data of 43 patients who were followed for > 6 months were analyzed. We evaluated range
of motion, grip strength, and HAND20 which is a validated subjective scoring system
in Japan.
Results All patients experienced relief from their ulnar wrist pain, and bone union was achieved
within an average of 2.6 months. The range of dorsiflexion improved from 63° preoperatively
to 69° postoperatively, grip strength compared with the contralateral hand improved
from 77% preoperatively to 87% postoperatively, and HAND20 improved from 41.3 points
preoperatively to 22.4 points postoperatively.
Discussion This procedure has advantages especially in early bone union. This procedure should
be taken into consideration as one of the options to treat ulnar abutment syndrome.
Keywords
TFCC - ulnocarpal impaction syndrome - ulnar shortening - nonunion - ulnar abutment
syndrome
