title: Isolated lunotriquetral ligament tears treated with ulnar shortening osteotomy.
abstract: OBJECTIVE
  To evaluate outcomes in a single-surgeon series of ulnar shortening osteotomy for the treatment of traumatic isolated tears to the lunotriquetral interosseous ligament (LTIL).
  
  
  METHODS
  This study includes 53 consecutive cases of posttraumatic isolated LTIL tears treated with ulnar shortening osteotomy with minimum 1-year follow-up (range, 1.0-10.6 y). We confirmed all LTIL tears via arthroscopy before performing a precision 2.5-mm oblique osteotomy using a modified Rayhack technique. We assessed outcomes using grip strength measurements and Chun and Palmer's modified Gartland Werley wrist scoring system, which includes subjective and objective outcome measures.
  
  
  RESULTS
  Preoperatively, 45 cases were graded as fair (28%; n = 15) or poor (57%; n = 30) on the modified Gartland Werley score. There were insufficient data to calculate grades in 8 cases (15%). At final follow-up, most patients exhibited excellent (51%; n = 27) or good (32%; n = 17) scores, some scored fair (17%; n = 9), and none scored as poor. All subjective and objective variables significantly improved over a mean follow-up of 36 months (range, 12-127 mo). Mean grip strength increased from a value of 23 kg before surgery to 33 kg over the same period, a 41% increase. All patients achieved clinical and radiographic union by 10 months. Osteotomy plates were removed routinely in most cases (89%; n = 47) at a mean of 17 months.
  
  
  CONCLUSIONS
  Ulnar shortening osteotomy reduced symptoms of posttraumatic isolated LTIL tears in this single-surgeon series.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Hand and Microsurgery, St. Catherine of Siena Medical Center, Smithtown, NY 11787, USA. research@amsurgical.com
authors.forename: Ather
authors.initials: A
authors.lastname: Mirza
authors.forename: Justin B
authors.initials: JB
authors.lastname: Mirza
authors.forename: Alexander Y
authors.initials: AY
authors.lastname: Shin
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Lorenzana
authors.forename: Brian K
authors.initials: BK
authors.lastname: Lee
authors.forename: Brett
authors.initials: B
authors.lastname: Izzo
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods; D050824:Carpal Joints / Q000000981:diagnostic imaging / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D015601:Injury Severity Score; D022125:Lacerations / Q000601:surgery*; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D013180:Sprains and Strains / Q000000981:diagnostic imaging / Q000601:surgery; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D051478:Triangular Fibrocartilage / Q000000981:diagnostic imaging / Q000601:surgery*; D014457:Ulna / Q000601:surgery*
keywords: Lunotriquetral; instability; ligament; ulnar shortening osteotomy