Metaphyseal ulnar shortening osteotomy for the treatment of ulnocarpal abutment syndrome using distal ulna hook plate: case series.
OBJECTIVE
To determine the efficacy of a transverse ulnar-shortening osteotomy at the metaphysis in combination with osteosynthesis using a low-profile, 2.0-mm, locking compression distal ulna plate for the treatment of ulnocarpal abutment syndrome.


METHODS
We enrolled into this prospective case series 6 patients with symptomatic ulnocarpal abutment syndrome without distal radioulnar joint ligamentous instability, who had previously failed conservative treatment. We recorded Quick Disability of Arm, Shoulder, and Hand score; wrist range of motion; and visual analog scale score for pain before and after surgery for statistical comparisons.


RESULTS
All parameters improved after the surgery. The Quick Disabilities of the Arm, Shoulder, and Hand improved from a mean of 65 to 17, and the visual analog score improved from a mean of 7 to 2. No hardware removal was required and no complications were reported.


CONCLUSIONS
Metaphyseal ulnar-shortening osteotomy provided the functional advantages of a midshaft ulnar-shortening osteotomy with the potential for improved bone healing and the reduced risk for complications. This technique was a useful alternative for treatment of ulnocarpal abutment syndrome, especially in patients with more than 2 mm ulnar positive variance.


METHODS
Therapeutic IV.
Hand and Upper Extremity Service, Centro Medico Guerra Mendez, Valencia, Venezuela. fnunez@wakehealth.edu
Fiesky A
FA
Nunez
Jonathan
J
Barnwell
Zhongyu
Z
Li
Fiesky A
FA
Nunez
D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D013577:Syndrome; D016896:Treatment Outcome; D014457:Ulna / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*