Chinese Journal of Reparative and Reconstructive Surgery
Supervisor： National Health Commission of the People's Republic of ChinaSponsor： Chinese Association of Rehabilitation Medicine , Sichuan University Editor-in-chief：Bin Shen Publishing period：
Monthly
ISSN：1002-1892CN：51-1372/R
1. The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 510405, P.R.China;
2. The 4th Department of Orthopeadics, Guangdong Provincial Traditional Chinese Medical Hospital Affiliated to Guangzhou University of Chinese Medicine, Guangzhou Guangdong, 520105, P.R.China;
Objective
To investigate the effectiveness of ulnar shortening osteotomy combined with elastic suspension fixation for ulnar impaction syndrome caused by relatively long ulna.
Methods
Between October 2015 and August 2016, 3 cases of ulnar impaction syndrome were treated. One patient was male and 2 patients were females. The age was 32, 29, and 59 years, respectively. One patient was dislocation and impaction of distal radioulnar joint for more than 1 year after internal fixation due to ulnar and radial open fractures. Other patients had no trauma and surgery, but long-term manual history. The visual analogue scale (VAS) scores were 7, 5, and 5, respectively. Cooney wrist function scores were rated as poor. Preoperative X-ray measurements of the ulnar variance was 12.7, 9.0, and 8.7 mm, respectively. The ulna was transversely osteotomy and fixed with plate and screws. The distal radioulnar joint was elastic suspension fixed with mini plate.
Results
Postoperative X-ray film showed that the matching of the distal radioulnar joint had no significant difference compared with the contralateral side. All the incisions healed by first intention without complication such as neurovascular injury, infection, and dislocation of the distal radioulnar joint. The patients were followed up 27, 17, and 23 months, respectively. At last follow-up, X-ray film showed that all osteotomy segments achieved bony union without internal fixation failure. The VAS scores were 2, 0, and 1, respectively, and the Cooney wrist function scores were rated as excellent.
Conclusion
The ulnar shortening osteotomy combined with elastic suspension fixation can correct the ulna variation, avoid the instability of the distal radioulnar joint caused by the extensive dissection of the tissue around the ulnar, and avoid stiffness of the joints caused by rigid fixation. It is an ideal treatment for ulna impaction syndrome.
Citation：ZHENG Muxin, LIN Xiaodong, XU Shuchai, LIU Hongliang, LIU Jian, HUANG Zexin. Combined ulnar shortening osteotomy and elastic suspended fixation in treatment of ulnar impaction syndrome. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(8): 993-996. doi: 10.7507/1002-1892.201802058Copy
Copyright ? the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
1.
Gelberman RH, Salamon PB, Jurist JM, et al. Ulnar variance in Kienb?ck’s disease. J Bone Joint Surg (Am), 1975, 57(5): 674-676.
2.
Pillukat T, Van Schoonhoven J, Lanz U. Ulnar instability of the carpus. Orthopade, 2004, 33(6): 676-684.
3.
L?w S, Herold A, Unglaub F, et al. Treatment of ulnar impaction syndrome with and without central TFC lesion. J Wrist Surg, 2018, 7(2): 133-140.
Teodoro RL, Nishimi AY, Pascarelli L, et al. Surgical treatment of acromioclavicular dislocation using the endobutton. Acta Ortop Bras, 2017, 25(3): 81-84.
13.
Eguchi A, Ochi M, Adachi N, et al. Mechanical properties of suspensory fixation devices for anterior cruciate ligament reconstruction: comparison of the fixed-length loop device versus the adjustable-length loop device. Knee, 2014, 21(3): 743-748.
14.
Petre BM, Smith SD, Jansson KS, et al. Femoral cortical suspension devices for soft tissue anterior cruciate ligament reconstruction: a comparative biomechanical study. Am J Sports Med, 2013, 41(2): 416-422.
15.
de Vries EN, Walenkamp MM, Mulders MA, et al. Minimally invasive stabilization of the distal radioulnar joint: a cadaveric study. J Hand Surg (Eur Vol), 2017, 42(4): 363-369.
16.
Kam CC, Jones CM, Fennema JL, et al. Suture-button construct for interosseous ligament reconstruction in longitudinal radioulnar dissociations: a biomechanical study. J Hand Surg (Am), 2010, 35(10): 1626-1632.
17.
Sang L, Liu H, Liu J, et al. A case report of distal radioulnar joint dislocation fixed by using mini-plate-button. Int J Surg Case Rep, 2017, 34: 69-73.
18.
Teodoro RL, Nishimi AY, Pascarelli L, et al. Surgical treatment of acromioclavicular dislocation using the endobutton. Acta Ortop Bras, 2017, 25(3): 81-84.
1. Gelberman RH, Salamon PB, Jurist JM, et al. Ulnar variance in Kienb?ck’s disease. J Bone Joint Surg (Am), 1975, 57(5): 674-676.
2. Pillukat T, Van Schoonhoven J, Lanz U. Ulnar instability of the carpus. Orthopade, 2004, 33(6): 676-684.
3. L?w S, Herold A, Unglaub F, et al. Treatment of ulnar impaction syndrome with and without central TFC lesion. J Wrist Surg, 2018, 7(2): 133-140.
12. Teodoro RL, Nishimi AY, Pascarelli L, et al. Surgical treatment of acromioclavicular dislocation using the endobutton. Acta Ortop Bras, 2017, 25(3): 81-84.
13. Eguchi A, Ochi M, Adachi N, et al. Mechanical properties of suspensory fixation devices for anterior cruciate ligament reconstruction: comparison of the fixed-length loop device versus the adjustable-length loop device. Knee, 2014, 21(3): 743-748.
14. Petre BM, Smith SD, Jansson KS, et al. Femoral cortical suspension devices for soft tissue anterior cruciate ligament reconstruction: a comparative biomechanical study. Am J Sports Med, 2013, 41(2): 416-422.
15. de Vries EN, Walenkamp MM, Mulders MA, et al. Minimally invasive stabilization of the distal radioulnar joint: a cadaveric study. J Hand Surg (Eur Vol), 2017, 42(4): 363-369.
16. Kam CC, Jones CM, Fennema JL, et al. Suture-button construct for interosseous ligament reconstruction in longitudinal radioulnar dissociations: a biomechanical study. J Hand Surg (Am), 2010, 35(10): 1626-1632.
17. Sang L, Liu H, Liu J, et al. A case report of distal radioulnar joint dislocation fixed by using mini-plate-button. Int J Surg Case Rep, 2017, 34: 69-73.
18. Teodoro RL, Nishimi AY, Pascarelli L, et al. Surgical treatment of acromioclavicular dislocation using the endobutton. Acta Ortop Bras, 2017, 25(3): 81-84.
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Citation：ZHENG Muxin, LIN Xiaodong, XU Shuchai, LIU Hongliang, LIU Jian, HUANG Zexin. Combined ulnar shortening osteotomy and elastic suspended fixation in treatment of ulnar impaction syndrome. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(8): 993-996. doi: 10.7507/1002-1892.201802058
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