title: The Oblique Metaphyseal Shortening Osteotomy of the Distal Ulna: Surgical Technique and Results of Ten Patients.
abstract: BackgroundUlnocarpal abutment is a common condition following distal radius fractures. There are different surgical methods of treatment for this pathology: open and arthroscopic wafer procedure or an ulnar shortening osteotomy. We describe an oblique metaphyseal shortening osteotomy of the distal ulna using two cannulated headless compression screws. We report the results of 10 patients treated with this method.Materials and MethodsOut of 17 patients, 10 could be reviewed retrospectively for this study. Patient-rated outcomes were measured using the VAS (visual analogue scale) for pain, PRWHE (patient-rated wrist and hand evaluation) survey, and Quick-DASH (disability of arm, shoulder and hand) survey for functional outcomes. At the review we measured the range of motion (ROM) of the wrist (extension and flexion, ulnar and radial deviation, pronation and supination). Grip strength, pronation, and supination strength of the forearm was measured using a calibrated hydraulic dynamometer. ROM and strength of the affected wrist was compared with ROM and strength of the unaffected wrist.Surgical ProcedureOblique long metaphyseal osteotomy of the distal ulna (from proximal-ulnar to distal-radial), fixed with two cannulated headless compression screws.ResultsThe average postoperative VAS score for pain was 23.71 (standard deviation [SD] of 30.41). The average postoperative PRWHE score was 32.55 (SD of 26.28). The average postoperative Quick-DASH score was 28.65 (SD of 27.21). The majority of patients had a comparable ROM and strength between the operated side and the non-operated side.ConclusionThis surgical technique has the advantage of reducing the amount of hardware and to decrease the potential hinder caused by it on medium term. Moreover, the incision remains smaller, and the anatomic metaphyseal localization of the osteotomy potentially allows a better and rapid healing.
authors.affiliation: Department of Orthopaedics and Traumatology, Upper Limb Unit, Orthoclinic Brugge, Bruges, Belgium; Department of Orthopaedics and Traumatology, University Hospital Ghent, Ghent, Belgium.
authors.forename: Szabolcs
authors.initials: S
authors.lastname: Benis
authors.affiliation: Department of Orthopaedics and Traumatology, Upper Limb Unit, Orthoclinic Brugge, Bruges, Belgium; Department of Orthopaedics and Traumatology, University Hospital Brussels (VUB-Vrije Universiteit Brussel), Jette, Belgium.
authors.forename: Jean F
authors.initials: JF
authors.lastname: Goubau
authors.affiliation: Department of Radiology, AZ Sint-Jan AV Brugge-Oostende, Campus Brugge, Bruges, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Mermuys
authors.affiliation: Department of Orthopaedics and Traumatology, Upper Limb Unit, Orthoclinic Brugge, Bruges, Belgium.
authors.forename: Petrus
authors.initials: P
authors.lastname: Van Hoonacker
authors.affiliation: Department of Orthopaedics and Traumatology, Upper Limb Unit, Orthoclinic Brugge, Bruges, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Berghs
authors.affiliation: Department of Orthopaedics and Traumatology, Upper Limb Unit, Orthoclinic Brugge, Bruges, Belgium.
authors.forename: Diederick
authors.initials: D
authors.lastname: Kerckhove
authors.affiliation: Department of Orthopaedics and Traumatology, Upper Limb Unit, Orthoclinic Brugge, Bruges, Belgium.
authors.forename: Bert
authors.initials: B
authors.lastname: Vanmierlo
keywords: headless compression screw; oblique metaphyseal osteotomy; ulnar shortening; ulnocarpal abutment