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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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Distal Radio-ulnar Joint Configurations in Patients with Idiopathic Ulnar Impaction Syndrome: A New Classification System

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  • presenting/speaker Yeun soo Kim - Seoul National University Hospital, Seoul, South Korea
  • Jihyeung Kim - Seoul National University Hospital, Seoul, South Korea
  • Kee Jeong Bae - Seoul National University Boramae Medical Center, Seoul, South Korea
  • Hyun Sik Gong - Seoul National University Bundang Hospital, Seongnam, South Korea
  • Goo Hyun Baek - Seoul National University Hospital, 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. DocIFSSH19-280

doi: 10.3205/19ifssh1348, urn:nbn:de:0183-19ifssh13488

Published: February 6, 2020

© 2020 Kim 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: Development of arthritis in the distal radioulnar joint (DRUJ) is a major concern after ulnar-shortening osteotomy. The configuration of the DRUJ is an important predisposing factor for arthritis. Here we suggest a new classification of the morphology of the DRUJ.

Methods: We retrospectively reviewed 26 wrists of 26 patients diagnosed with idiopathic ulnar impaction syndrome and assessed their preoperative three-dimensional computed tomography (CT) findings. We measured the slopes of the sigmoid notch and ulnar head in the middle of the DRUJ. We also simulated the changes in the joint space in the DRUJ after 2 mm ulnar shortening.

Results and Conclusions: The average ulnar variance was 3.4 mm. The slope of the sigmoid notch and that of the ulnar head were not parallel. The slope of the sigmoid notch ranged from -23.9° to 19.3° and that of ulnar head from -24.0° to 17.0°. There was a significant correlation between the slope of the ulnar head and the changes in the joint space of the DRUJ at the center of the sigmoid notch after 2 mm ulnar shortening.

The slope of the ulnar head might be as important a predisposing factor as that of the sigmoid notch for the progression of DRUJ arthritis after ulnar-shortening osteotomy. In our new classification system, we considered the slope of both the sigmoid notch and ulnar head.