Treatment Of Ulnar Impaction Syndrome Using Sliding Compression Osteotomy
Abdel Hakim A. Abdalla Massoud, MD, Dept. of Orthopedic Surgery, Al Azhar University, Effingham, IL, Amro Ahmed Fouaad Attia, MD, Al-Azhar University, Cairo, Egypt and Nash Naam, MD, Plastic and Reconstructive Surgery, Southern Illinois Hand Center and Southern Illinois University, Effingham, IL
Introduction: Ulnar shortening osteotomy may be recommended to decompress the ulnar carpus and TFCC in case of ulnar impaction syndrome. In this article we describe a simple technique of ulnar shortening that allow guided shortening using small DCP or LCP.
Patients: A prospective case series study was conducted on 30 patients with positive ulnar variance, 12 of them had post traumatic positive ulnar variance secondary to radial shortening of less than 4mm. The average age was 31.4 years, the dominant hand involved in 17 patients.
The technique of ulnar shortening osteotomy consisted of oblique ulnar osteotomy using 3 mm thick saw blade and fixation using small DCP or LCP plate. The desired shortening achieved by allowing the distal fragment to slide proximally while compressing the osteotomy site
Results: After a mean follow up of 5.1 years, the mean ulnar sided wrist pain improved on VAS from 6.7 to 1.8. The mean Mayo wrist score
The technique used in this study is simple and effective in treatment of ulnar impaction syndrome specially when special instrument and expensive implant for ulnar shortening are unavailable.
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