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Clinical, radiographic, and arthroscopic outcomes after ulnar shortening osteotomy: a long-term follow-up study.
MedLine Citation:
PMID:  23174060     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: Previous studies have investigated the long-term outcomes of ulnar shortening osteotomy (USO) in the treatment of ulnocarpal abutment syndrome (UCA), but none have used arthroscopic assessments. The purpose of this study was to investigate the long-term clinical outcomes of USO with patient-based, arthroscopic, and radiographic assessments.
METHODS: We retrospectively reviewed 30 patients with UCA after a minimum follow-up of 5 years, with arthroscopic evaluations at the time of both USO and plate removal. We confirmed the initial diagnosis of UCA by radiography and arthroscopy. Mean age at the time of index surgery was 37 years. Mean duration of follow-up was 11 years (range, 5-19 y). We obtained Disabilities of the Arm, Shoulder, and Hand and Hand20 self-assessments postoperatively for all patients. Bony spur formation was evaluated postoperatively from plain radiographs.
RESULTS: We detected triangular fibrocartilage complex (TFCC) disc tear in 13 wrists arthroscopically at the time of USO. Of these, 10 showed no evidence of TFCC disc tear at second-look arthroscopy. The remaining 17 cases showed no TFCC disc tear at either first- or second-look arthroscopy. Follow-up radiography revealed that bony spurs at the distal radioulnar joint had progressed in 13 wrists. Disabilities of the Shoulder, Arm, and Hand and Hand20 scores did not significantly correlate with the presence of bony spurs or TFCC disc tears. Range of motion decreased significantly with age only. Lower grip strength correlated with bony spur and lower radial inclination. Triangular fibrocartilage complex tear, male sex, and advanced age were associated with lower Disabilities of the Shoulder, Arm, and Hand and Hand20 scores.
CONCLUSIONS: Ulnar shortening osteotomy achieved excellent long-term results in most cases. Most TFCC disc tears identified at the initial surgery had healed by long-term arthroscopic follow-up. We suggest that UCA with a TFCC disc tear is a good indication for USO.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
Authors:
Masahiro Tatebe; Takaaki Shinohara; Nobuyuki Okui; Michiro Yamamoto; Hitoshi Hirata; Toshihiko Imaeda
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  37     ISSN:  1531-6564     ISO Abbreviation:  J Hand Surg Am     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2468-74     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Hand Surgery, Nagoya University School of Medicine; and the Department of Food and Nutritional Environment, Kinjo Gakuin University School of Human Life and Environment, Nagoya, Japan. Electronic address: tatebe@med.nagoya-u.ac.jp.
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