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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Preliminary results after ulnar shortening osteotomy using a “low-profile” locking plate with an ulnopalmar approach

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  • presenting/speaker Athanasios Terzis - BG Trauma Center Frankfurt am Main, Frankfurt am Main, Germany
  • Florian Neubrech - BG Trauma Center Frankfurt am Main, Frankfurt am Main, Germany
  • Julia Sebald - BG Trauma Center Frankfurt am Main, Frankfurt am Main, Germany
  • Michael Sauerbier - BG Trauma Center Frankfurt am Main, Frankfurt am Main, Germany

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-744

doi: 10.3205/19ifssh0404, urn:nbn:de:0183-19ifssh04049

Published: February 6, 2020

© 2020 Terzis et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: The most common cause for symptomatic ulnar impaction syndrome is either a malunion after distal radius fracture or the congenital ulnar plus variance. Decompression of the ulnocarpal joint with ulnar shortening osteotomy is the commonly used treatment. The purpose of the study was to investigate the effectiveness of ulnar shortening osteotomy using a new, ''low-profile'' locking plate. With this device the closure of the osteotomy gap is performed with a compression spindle.

Methods: Between June 2016 and March 2018 ulnar shortening osteotomy was performed in 20 patients using the new locking plate. 12 patients were male and 8 patients female at a mean age of 46 years. The indication for ulnar shortening was in 8 patients a malunion after distal radius fracture, in 12 patients a congenital positive ulnar-plus variance. 14 of the 20 patients underwent a previous arthroscopic debridement of the TFCC area.

The osteotomy of the ulna was done in all patients in an ulnopalmar approach and the osteotomy in 45° degrees. Arc of motion, grip strength (Jamar Dynamometer), pain (using the Visual Analogue Scale) and activities of daily living (DASH Score) as well as radiological outcome were assessed.

Results and Conclusions: Mean follow-up time was 11.3 months. There was a significant pain reduction (VAS; 7.2 to 2.2, p<0.05) and improvement of function (DASH; 50.44 to 27.4, p<0.05). Range of motion and grip strength improved as well compared to the contralateral side. The average ulnar shortening was 3.5 (1.5-7) mm. Bony union was achieved in all patients after a mean time of 4 months. Overall patient satisfaction was rated by 18/20 patients as very good, 1/20 as good and 1/20 as not good. There was no implant associated complication. The mean time required to return to work was 4.7 months. Ulnar shortening osteotomy using a low profile locking plate allows for an exactly defined oblique osteotomy as well as a safe closure of the osteotomy gap using a compression spindle. There was no nonunion or other implant associated complication in our series. Overall patient satisfaction was high.