title: [Arthroscopic partial resection of the ulnar head for ulnocarpal decompression].
abstract: OBJECTIVE
  Arthroscopic decompression (wafer procedure) of the ulnocarpal compartment in patients with ulnar impaction syndrome.
  
  
  METHODS
  The arthroscopic wafer procedure is recommended in ulnar-plus situations with up to 3 mm length-excess. To perform this procedure the ulnar head needs to be accessible for the burr through a pre-existing, impaction-related, centroradial lesion of the triangular fibrocartilage complex (TFCC). The additional presence of a distal radioulnar joint (DRUJ) type C confirms the indication.
  
  
  METHODS
  The wafer procedure is contraindicated if there is no consistent TFCC injury ensuring access to the ulnar head and furthermore in ulna-plus situations of more than 3 mm. Relative contraindications: in young patients due to lack of evidence-based studies.
  
  
  METHODS
  Arthroscopic, semicircular, partial resection of the ulnar head in terms of oblique-helicoidal osteotomy using a 4.2 mm burr, while sparing the DRUJ and the dorsal and the palmar radioulnar ligaments.
  
  
  METHODS
  Immobilization for 1 week in a palmar splint with immediate intensive exercising of pro- and supination under physiotherapeutic instruction.
  
  
  RESULTS
  Between 2008 and 2010, an arthroscopic wafer procedure was performed in 24 patients. The resection of the ulnar head was 2.5 mm on average. After a mean follow-up time of 13.25 months, very good results were archived in 23 of 24 patients; the ulnar impingement test was negative. On a visual analog scale (0-10) average postoperative pain was 1.16 at rest and 4.5 under stress. The mean postoperative DASH score was 13.4.
authors.affiliation: Klinik für Handchirurgie und Plastische Chirurgie, Orthopädische Klinik Markgröningen, Kurt-Lindemann-Weg 10, 71706, Markgröningen, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Del Gaudio
authors.affiliation: Klinik für Handchirurgie und Plastische Chirurgie, Orthopädische Klinik Markgröningen, Kurt-Lindemann-Weg 10, 71706, Markgröningen, Deutschland. Max.Haerle@okm.de.
authors.forename: M
authors.initials: M
authors.lastname: Haerle
mesh_terms: D001182:Arthroscopy / Q000379:methods*; D002348:Carpal Bones / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods; D013577:Syndrome; D016896:Treatment Outcome; D051478:Triangular Fibrocartilage / Q000601:surgery*; D014457:Ulna / Q000601:surgery*; D014954:Wrist Injuries / Q000175:diagnosis / Q000601:surgery*; D014955:Wrist Joint / Q000601:surgery
keywords: Arthroscopy; Triangular fibrocartilage complex; Ulna impaction syndrome; Wafer procedure; Wrist joint