title: Ulnar impaction syndrome: incidence of lunotriquetral ligament degeneration and outcome of ulnar-shortening osteotomy.
abstract: OBJECTIVE
  We hypothesized that most patients with ulnar impaction syndrome have degenerative changes of the proximal lunotriquetral (LT) membrane and that ulnar-shortening osteotomy is an effective procedure in these patients.
  
  
  METHODS
  We retrospectively reviewed 50 wrists of 49 patients with idiopathic ulnar impaction syndrome who underwent an arthroscopic evaluation at the time of ulnar-shortening osteotomy, and subsequently at plate removal. Based on the Geissler classification, patients were divided into group A, normal, and group B, grades I to IV. The degree of degeneration of the proximal LT membrane at first-look arthroscopy was compared with that at second-look arthroscopy.
  
  
  RESULTS
  After ulnar-shortening osteotomy, both groups improved significantly in wrist range of motion and grip strength. According to the Mayo wrist score, 29, 18, and 3 patients showed excellent, good, and fair results, respectively. Of the 50 wrists, 25 had degenerative changes (group B) in the proximal LT membrane at the time of first-look arthroscopy. Of the 25 wrists in group B, 11 wrists improved based on the Geissler grade, 9 wrists showed no changes, and 2 wrists became worse. Clinically, patients demonstrated improvement after ulnar-shortening osteotomy regardless of the degree of degenerative LT ligament changes.
  
  
  CONCLUSIONS
  Degenerative LT membrane changes that were seen in about half of our patients were mostly of a mild nature, and the clinical outcomes of ulnar-shortening osteotomy were acceptable.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Hand Surgery, Nagoya University Graduate School of Medicine; Hand Surgery Center, Chunichi Hospital, Nagoya; Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan. Electronic address: kiwatsuki@med.nagoya-u.ac.jp.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Iwatsuki
authors.affiliation: Department of Hand Surgery, Nagoya University Graduate School of Medicine; Hand Surgery Center, Chunichi Hospital, Nagoya; Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tatebe
authors.affiliation: Department of Hand Surgery, Nagoya University Graduate School of Medicine; Hand Surgery Center, Chunichi Hospital, Nagoya; Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan.
authors.forename: Michiro
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Hand Surgery, Nagoya University Graduate School of Medicine; Hand Surgery Center, Chunichi Hospital, Nagoya; Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Shinohara
authors.affiliation: Department of Hand Surgery, Nagoya University Graduate School of Medicine; Hand Surgery Center, Chunichi Hospital, Nagoya; Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan.
authors.forename: Ryogo
authors.initials: R
authors.lastname: Nakamura
authors.affiliation: Department of Hand Surgery, Nagoya University Graduate School of Medicine; Hand Surgery Center, Chunichi Hospital, Nagoya; Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hirata
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018771:Arthralgia; D001182:Arthroscopy; D005260:Female; D018737:Hand Strength; D006801:Humans; D015994:Incidence; D007592:Joint Diseases / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014457:Ulna / Q000473:pathology / Q000601:surgery*; D014955:Wrist Joint
keywords: Lunotriquetral ligament; ulnar impaction syndrome; ulnar-shortening osteotomy; ulnocarpal abutment syndrome; ulnocarpal impaction syndrome