Clinical, Radiographic, and Arthroscopic Outcomes After Ulnar Shortening Osteotomy: A Long-Term Follow-Up Study

被引:21
作者
Tatebe, Masahiro
Shinohara, Takaaki
Okui, Nobuyuki
Yamamoto, Michiro
Hirata, Hitoshi
Imaeda, Toshihiko
机构
[1] Nagoya Univ, Dept Hand Surg, Sch Med, Nagoya, Aichi 4668550, Japan
[2] Kinjo Gakuin Univ, Sch Human Life & Environm, Dept Food & Nutr Environm, Nagoya, Aichi, Japan
来源
JOURNAL OF HAND SURGERY-AMERICAN VOLUME | 2012年 / 37A卷 / 12期
关键词
Ulnar shortening osteotomy; ulnar wrist pain; arthroscopy; triangular fibrocartilage complex;
D O I
10.1016/j.jhsa.2012.09.011
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
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. Copyright (C) 2012 by the American Society for Surgery of the Hand. All rights reserved.
引用
收藏
页码:2468 / 2474
页数:7
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