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      Hardware Location and Clinical Outcome in Ulna Shortening Osteotomy

      research-article
      Author(s): , MD * , , , MD † , , MD, PhD ‡ , , MD, PhD §
      Publication date (Electronic):
      Journal: Plastic and Reconstructive Surgery Global Open
      Publisher: Wolters Kluwer Health

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Background:

          The purpose of this study was to investigate the influence of plate location during ulna shortening osteotomy on the incidence of hardware irritation and clinical outcome.

          Methods:

          Forty patients (17 women, 23 men; mean age, 47 years) who underwent a shortening osteotomy of the ulna due to idiopathic ulna impaction syndrome were examined after a mean of 36 months. All complications and secondary procedures were extracted from the patients’ records.

          Results:

          The rate of hardware removal was higher in patients who had a dorsal placement of the plate in comparison with ulnar or palmar placements, although this difference was not statistically significant. Apart from hardware irritation, there were 4 nonunions, 1 secondary osteoarthritis of the distal radioulnar joint, and 1 case of chronic irritation of the dorsal branch of the ulnar nerve, which required secondary surgery. The incidence of secondary surgery other than hardware removal was not significantly related to the original location of the plate.

          Conclusions:

          Secondary surgery after ulnar shortening osteotomy is common. However, we found no difference in clinical outcomes based on plate location.

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          Most cited references20

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          [The DASH(Disability of Arm-Shoulder-Hand) Questionnaire--a new instrument for evaluating upper extremity treatment outcome].

          A Harth, G Wind, Paul G Germann (1999)
          The paper presents the translation of a new measurement tool, the DASH Questionnaire. The DASH (Disability of Arm--Shoulder--Hand) is an outcomes data collection instrument which has been developed by the "American Academy of Orthopaedic Surgeons", the Council of the "Musculoskeletal Specialty Societies", and the "Institute for Work and Health", in order to assess outcomes among patient groups with musculoskeletal disorders. Using a self-report system, patients attribute scores of 1 to 5 on 30 items relating to functional activities and symptoms; a further optional module contains four items relating to disability levels among musicians and athletes. The raw score is then transformed to a 0 to 100 scale, whereby 0 reflects minimum and 100 maximum disability. The subjective nature of this instrument makes it suitable for both postal or in situ clinical surveys. The instrument is in the process of validation for use with a German population.
          Article 0 comments Cited 33 times – based on 0 reviews     Review now
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            Ulnar variance determination.

            Scott Glisson, Matthew B Palmer, F. Werner (1982)
            Article 0 comments Cited 17 times – based on 0 reviews     Review now
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              Comparison of ulnar shortening osteotomy and the wafer resection procedure as treatment for ulnar impaction syndrome.

              M Tomaino, D Sotereanos, M. Herndon … (1999)
              A retrospective review was performed that compared the results of 2 different surgical treatments for ulnar impaction syndrome in 22 patients over a 6-year period. Ulnar shortening osteotomy and wafer distal ulna resection (wafer resection procedure) were each performed in 11 patients based on the preference of 3 individual hand surgeons. All patients presented with ulnar wrist pain and positive ulnar variance on either neutral rotation or pronated-grip x-rays and each failed conservative management. At a minimum follow-up time of 18 months, 9 patients had good to excellent results following ulnar shortening osteotomy compared with 8 following the wafer resection procedure. This difference was not statistically significant. All patients regained functional wrist motion and 21 of the 22 patients had satisfactory pain relief. There was 1 poor result in the wafer group that required revision to complete resection of the distal ulna. Five secondary procedures were required in the osteotomy group to remove painful hardware and union was delayed in 2 patients. Although ulnar shortening osteotomy provides effective treatment for ulnar impaction syndrome, the wafer resection procedure provides favorable pain relief and restoration of function but without the potential for nonunion or hardware removal. (J Hand Surg 2000; 25A:55-60. Copyright 2000 by the American Society for Surgery of the Hand.).
              Article 0 comments Cited 16 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Plast Reconstr Surg Glob Open
                Journal ID (iso-abbrev): Plast Reconstr Surg Glob Open
                Journal ID (publisher-id): GOX
                Title: Plastic and Reconstructive Surgery Global Open
                Publisher: Wolters Kluwer Health
                ISSN (Electronic): 2169-7574
                Publication date Collection: October 2015
                Publication date (Electronic): 26 October 2015
                Volume: 3
                Issue: 10
                Electronic Location Identifier: e549
                Affiliations
                From the [* ]Clinic for Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; [† ]Department of Plastic Surgery, Evangelical Hospital Göttingen-Weende, Göttingen, Germany; [‡ ]Clinic for Plastic, Reconstructive and Aesthetic Surgery and Preventive Medicine, Heidelberg University Hospital, Ethianum Heidelberg, Heidelberg, Germany; and [§ ]Department for Plastic, Hand and Reconstructive Surgery, BG Unfallklinik Frankfurt, Frankfurt, Germany.
                Author notes
                Kai Megerle, MD, Clinic for Plastic Surgery and Hand Surgery, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Straße 22, 81675 Munich, Germany, E-mail: kai.megerle@ 123456mri.tum.de
                Article
                Accession ID: 00006
                DOI: 10.1097/GOX.0000000000000521
                PMC ID: 4634186
                PubMed ID: 26579355
                SO-VID: 500113ef-c374-4120-a6e6-8509b641bbf4
                Copyright © Copyright © 2015 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

                History
                Date received : 28 May 2015
                Date accepted : 1 September 2015
                Categories
                Subject: Original Article
                Custom metadata
                OPEN-ACCESS TRUE

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