[Surgical treatment of ulnar impaction syndrome : Ulnar shortening osteotomy through the ulnopalmar approach using a low-profile, locking plate].

OBJECTIVE

Extra-articular shortening of the distal ulna in order to decompress the ulnocarpal joint.

INDICATIONS

Congenital or posttraumatic, symptomatic ulnar impaction syndrome.

CONTRAINDICATIONS

Osteoarthritis or deformation of the distal radioulnar joint.

SURGICAL TECHNIQUE

Exactly defined oblique osteotomy in the distal third of the ulna using the saw guide, closing of the osteotomy gap using the compression spindle, osteosynthesis with the locking plate.

POSTOPERATIVE MANAGEMENT

Palmar forearm thermoplastic cast or splint for 3 weeks, load bearing after bony union.

RESULTS

Between June 2016 and March 2018 ulnar shortening was performed in 17 patients using the new locking plate. In all, 15 patients were reevaluated with complete follow-up data. Postoperatively patients experienced significant pain reduction (Visual Analog Scale 0-10) by 65% (7 before and 2.5 after surgery; p < 0.05) and a significant improvement of function (Disabilities of Arm, Shoulder and Hand 0-100) by 49% (47 before and 24 after surgery; p < 0.05). Bony union was observed in all patients after a mean time of 4 months. Overall patient satisfaction was high.