title: Time-Dependent Recovery of Outcome Parameters in Ulnar Shortening for Positive Ulnar Variance: A Prospective Case Series.
abstract: BACKGROUND
  This study evaluates the results of ulnar shortening using the ulna osteotomy locking plate system (UOL; I.T.S. GmbH, Graz, Austria) with special regard to the time-dependent recovery of subjective and objective outcome parameters and surgeons' experiences.
  
  
  METHODS
  Ulnar shortening using the UOL was performed on 11 patients (3 men, 8 women) with an average age of 47 ± 19.6 years. Range of motion (ROM) and grip strength were compared with the contralateral hand. Patient-rated outcomes were measured using a visual analogue scale (VAS) for pain and the Disability of the Arm, Shoulder and Hand (DASH) and the Patient Rated Wrist Evaluation (PRWE) survey for subjective outcomes. Ulnar variance and bony union were assessed using conventional wrist radiographs. The surgeons evaluated intraoperative handling through a standardized feedback form.
  
  
  RESULTS
  ROM improved and grip strength increased significantly between preoperative values and final follow-up. Flexion and supination improved significantly between weeks 8 and 12 and grip strength from week 8 onward. Patient-rated outcomes changed significantly with a final DASH score of 14.2 ± 12.4 and a PRWE score of 24.3 ± 17.0. Pain levels improved significantly with no pain at rest and a mean VAS of 0.8 ± 1.2 during activity. The average amount of shortening was 4.0 ± 1.9 mm with a final ulnar variance of 0.2 ± 1.8 mm. All osteotomies healed with 2 cases of delayed union.
  
  
  CONCLUSIONS
  In ulnar shortening with the UOL, wrist function recovered after an initial decrease from week 8 onward. Subjective outcome parameters showed early recovery and improved continuously over time.
authors.affiliation: 1 Medical University of Innsbruck, Austria.
authors.forename: Gernot
authors.initials: G
authors.lastname: Schmidle
authors.affiliation: 1 Medical University of Innsbruck, Austria.
authors.forename: Tobias
authors.initials: T
authors.lastname: Kastenberger
authors.affiliation: 1 Medical University of Innsbruck, Austria.
authors.forename: Rohit
authors.initials: R
authors.lastname: Arora
mesh_terms: D004185:Disability Evaluation; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation* / Q000379:methods; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D014457:Ulna / Q000503:physiopathology / Q000601:surgery*; D064232:Visual Analog Scale; D014955:Wrist Joint / Q000502:physiology
keywords: positive ulnar variance; recovery; time dependent; ulna leveling; ulna osteotomy locking plate; ulnar impaction syndrome; ulnar shortening osteotomy; wrist pain