Outcomes of ulnar shortening osteotomy fixed with a dynamic compression system

J Hand Surg Am. 2013 Aug;38(8):1520-3. doi: 10.1016/j.jhsa.2013.04.040. Epub 2013 Jul 3.

Abstract

Purpose: To evaluate the outcomes of patients with ulnar impaction syndrome treated with a jig-facilitated, oblique, diaphyseal ulnar shortening osteotomy and fixed with a TriMed (Santa Clarita, CA) ulnar osteotomy compression plate.

Methods: A retrospective chart review of patients with ulnar impaction syndrome identified 38 patients who had had ulnar shortening osteotomy and fixation with the TriMed dynamic compression system. The following clinical data were obtained: patient age, sex, follow-up range of motion, grip strength, and complications. After a minimum of 2 years after surgery, patients reported complications and completed a Disabilities of the Arm, Shoulder, and Hand questionnaire.

Results: Eight patients were lost to follow-up. Compared to the opposite limb at an average of 8 months after surgery, the remaining 30 patients attained 92% to 97% of wrist and forearm motion and 71% of grip strength. The average Disabilities of the Arm, Shoulder, and Hand score was 12 after a minimum of 2 years after surgery. Four patients required plate removal due to irritation. Two patients reported persistent ulnar-sided pain, and 2 other patients developed atrophic nonunions and required autologous bone grafting. There were no infections.

Conclusions: Ulnar shortening osteotomy using the TriMed system yielded good clinical outcomes that are comparable to those previously documented using other systems.

Type of study/level of evidence: Therapeutic IV.

Keywords: Compression plate; positive ulnar variance; triangular fibrocartilage complex; ulnar shortening osteotomy.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroscopy / methods
  • Bone Plates*
  • Bridged Bicyclo Compounds, Heterocyclic
  • Cohort Studies
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Diseases / surgery*
  • Osteotomy / instrumentation*
  • Osteotomy / methods
  • Pain Measurement
  • Range of Motion, Articular / physiology*
  • Recovery of Function
  • Retrospective Studies
  • Risk Assessment
  • Succinimides
  • Treatment Outcome
  • Triangular Fibrocartilage / physiopathology
  • Triangular Fibrocartilage / surgery
  • Ulna / physiopathology
  • Ulna / surgery*
  • Young Adult

Substances

  • Bridged Bicyclo Compounds, Heterocyclic
  • Succinimides
  • sunepitron