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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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Does Degeneration of Triangular Fibrocartilage Complex Improve after Ulnar Shortening Osteotomy?

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  • presenting/speaker Che Ho Lee - Seoul National University, College of Medicine, Seoul, South Korea
  • Jihyeung Kim - Seoul National University, College of Medicine, Seoul, South Korea
  • Hyun Sik Seok - Seoul National University, College of Medicine, Seoul, South Korea
  • Kee Jeong Bae - Seoul National University, College of Medicine, Seoul, South Korea
  • Hyun Sik Gong - Seoul National University, College of Medicine, Seoul, South Korea
  • Young Ho Lee - Seoul National University, College of Medicine, Seoul, South Korea
  • Goo Hyun Baek - Seoul National University, College of Medicine, Seoul, South Korea

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. DocIFSSH19-565

doi: 10.3205/19ifssh0406, urn:nbn:de:0183-19ifssh04062

Published: February 6, 2020

© 2020 Lee 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 degeneration of the triangular fibrocartilage complex (TFCC) is usually combined in patients with ulnar impaction syndrome. Because ulnar shortening osteotomy can decrease the load-sharing through the ulnar carpus, there may be a possibility of indirect healing of TFCC degeneration after ulnar shortening. In this study, we focused on the changes of the TFCC degeneration after ulnar shortening osteotomy using 3D CT wrist arthrography.

Methods: We retrospectively reviewed all patients who were diagnosed as ulnar impaction syndrome and underwent ulnar shortening osteotomy from January 2014 to December 2016. Of them, we enrolled 18 wrists of 15 patients who had checked 3D CT wrist arthrography preoperatively and checked postoperative CT wrist arthrography repeatedly one year after surgery. The average age at the time of surgery was 37 years.

Results and Conclusions: In all patients, the degeneration of TFCC was observed in preoperative CT wrist arthrography. Six wrists were IIA, three were IIB, seven were IIC, and one was IID according to Palmer classification. One year after surgery, the degeneration of TFCC improved in three wrists, and worsened in two wrists. In the other twelve wrists, there were no changes in the degeneration of TFCC. The average visual analog scale (VAS) for pain was improved from 7 (range, 5~9) preoperatively to 3 (range, 0~6) one year after surgery. Although ulnar side wrist pain was much improved after ulnar shortening osteotomy, indirect healing of the TFCC degeneration was not observed in most of our cases one year after surgery. Therefore, we can conclude that indirect healing of the TFCC degeneration may need more time or may not occur after ulnar shortening osteotomy. The degeneration of the TFCC may not seem to be the main cause of the ulnar side wrist pain in patients with ulnar impaction syndrome.