gms | German Medical Science

Objectives/Interrogation: The ulnar impaction syndrome is a source of ulnar wrist pain. The diagnosis includes physical examination and radiological signs of ulnar impaction, although not all cases of radiographic impactions are symptomatic.

The objective of the study is to evaluate the results of ulnar shortening osteotomy fixed with a compression plate on the volar face of ulna for primary ulnar impaction syndrome, 8 years of follow up.

Methods: Retrospective review of 10 patients with primary ulnar impaction syndrome intervened in 2009 and 2010, mean follow up of 8,7 years.

The following data observed genre, age, range of motion (pronation, supination and Kapandji scale), grip strength, pinch strength, VAS and DASH.

A P-A and lateral x-ray of forearm were made for assessment changes on distal radio-ulnar joint ant carpal-ulnar joint.

Results and Conclusions: 10 patients (6 women, 4 men), mean age 44.4 years (26-62 years). 3 were intervened on the left hand. All patients had right dominance.

Intervention was made with Acumed Osteotomy System (Acumed®) with mean shortening of 2,3 cm.

The osteotomy consolidation was achieved between 2-10 months (mean 6.3). 4 patients were intervened for extraction of the material due to discomfort. The extraction was made between 1 and 7 years (mean 3 years).

Just one x-ray showed a distal radius osteophyte.

Results were analysed using Wilcoxon test.

Mean values of grip strength was 26,8 kg and pinch mean strength was 7,4 kg, we did not found statistical difference compared to contralateral (grip strength p = 0,345, pinch strength p = 0,35).

Mean values of pronation was 90º, supination was 83,5º, Kapandji 9,6. There was no difference on the range of motion between both extremities (pronation p = 0, supination p = 0,109, Kapandji p = 0,317).

There was no difference on the VAS scale, mean value of 0.9 points (p = 0,317). The DASH score mean results were 12,72 points.

A correlation was found using Spearman test between the DASH scale and both the grip strength (p < 0,05) and the pinch strength (p < 0,05). There was no difference between VAS scale results and grip (p = 0,059) or punch strengths (p = 0,127).

We concluded that ulnar shortening provides excellent long-time results, with no difference on either motion values (pronation, supination, Kapandji scale, grip strength and punch strength), VAS or DASH between the intervened extremity and the collateral at 8 years after the procedure.

It also suggest that DASH may have better correlation with surgical results in terms of strength than VAS.