title: Ulna-Shortening Osteotomy: Outcome and Repercussion of the Distal Radioulnar Joint Osteoarthritis.
abstract: BACKGROUND
  Ulnocarpal impaction syndrome occurs mostly in patients with positive ulnar variance. Ulnar-shortening osteotomy is a commonly used method to correct it, but degenerative changes may appear in the distal radioulnar joint. The authors evaluated outcome after ulnar-shortening osteotomy, particularly the impact of distal radioulnar joint osteoarthritis.
  
  
  METHODS
  A 10-year study was performed of patients who underwent ulnar-shortening osteotomy.
  
  
  RESULTS
  Forty-six patients were available for clinical examination and radiography. Twenty-nine wrists showed worsening or new osteoarthritis. A difference of preulnar variance and resection was noted: 4.64 mm and 4.48 mm, respectively, in the osteoarthritis group versus 3.50 mm and 3.38 mm in the group without osteoarthitis. Comparison of patients with osteoarthritis revealed a significant limitation of range of motion in flexion-extension (p = 0.009) and pronosupination (p = 0.028): 102 degrees and 138 degrees, respectively, in the osteroarthritis group versus 124 degrees and 155 degreees in the group without osterarthritis. The type of distal radioulnar joint differed significantly (p = 0.038), with a predominance of type I in the osterarthritis group and type II in the group without osterarthritis. Functional outcome was significantly worse in the osterarthritis group versus the group without osteoarthritis concerning the Patient-Rated Wrist Evaluation score (39.07 versus 22.59, p = 0.031), the Quick Disabilities of the Arm, Shoulder, and Hand score (27.38 versus 19.59, p = 0.017), and the modified Gartland-Werley score (76.72 versus 85.14, p = 0.027).
  
  
  CONCLUSIONS
  Ulnar-shortening osteotomy modifies the congruence of the distal radioulnar joint, and the type I joint may be at increased risk of arthrosis. Osteoarthritis has a clinical impact, and the amount of ulnar shortening should be limited to what is needed to avoid altering the functional outcome.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Nancy, France From the Centre Chirurgical Emile Gallé, Nancy University Hospital; and the University of Lorraine.
authors.forename: Antoine
authors.initials: A
authors.lastname: de Runz
authors.forename: Nicolas
authors.initials: N
authors.lastname: Pauchard
authors.forename: Thomas
authors.initials: T
authors.lastname: Sorin
authors.forename: François
authors.initials: F
authors.lastname: Dap
authors.forename: Gilles
authors.initials: G
authors.lastname: Dautel
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D010027:Osteotomy / Q000009:adverse effects* / Q000379:methods; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D014457:Ulna / Q000601:surgery*; D014955:Wrist Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology