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Journal of the Korean Society for Surgery of the Hand 2006;11(1):14-19.
Published online March 1, 2006.
Results of Ulnar Shortening for Ulnar Impaction Syndrome in the Wrist
Jong Woong Park, Sung Kon Kim, Jung Ho Park, Jun Ho Wang, Seoung Joon Lee, Woo Joo Jeon
완관절 척측 충돌 증후군에서 척골 단축술의 결과
박종웅, 김성곤, 박정호, 왕준호, 이승준, 전우주
Abstract
Purpose
We evaluated the results of oblique ulnar shortening osteotomy and arthroscopic debridement performed for the ulnar impaction syndrome. Materials and Methods: Seven wrists (6 patients) were involved. Routine wrist radiograph series, arthrography, and MRI arthrography were performed for the diagnosis. The presence of ulnar variance, TFCC or intercarpal ligament injuries, and ulnar head or carpal bone chondromalacia were evaluated and finally confirmed by the wrist arthroscope. The TFCC and intercarpal ligaments tear were debrided and thermal shrinkage was performed under the arthroscpe. Positive ulnar variance was corrected by an oblique ulnar shortening osteotomy fixed with a dorsally applied AO DCP and an interfragmentary lag screw fixation. The results were evaluated following to the Chun & Palmer’s wrist grading system. Results: Five cases of Palmar 2C and 2 cases of 2D were identified. Preoperative wrist grades were fair in 2 cases, poor in 5 cases and they were finally improved to excellent in 5 cases, good in 1 case and fair in 1 case. Average pre-operative wrist score was 64 and finally improved to 92. There was no nonunion at osteotomy site. Ulnar variance changed to -0.4mm from +2.7mm. Conclusion: The arthroscopic debridement and an ulnar shortening osteotmy is a good treatment option for the ulnar impaction syndrome with a positive ulnar variance. The oblique osteotomy and rigid fixation using a DCP and interfragmentary lag screw can be performed easily and is good for the rotational control and early mobilization of the joint.
 


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