Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
J Hand Surg Asian Pac Vol. 2020 Dec;25(4):441-446. doi: 10.1142/S2424835520500484.
Ulnar shortening osteotomy (USO) is a well-established procedure for ulnar impaction syndrome. Various types of osteotomies have been described. A retrospective cohort study was conducted to compare the results of transverse osteotomy (TO) fixed with a small fragment dynamic compression plate (Synthes, Pennsylvania, USA), to oblique osteotomy (OO) fixed with a procedure specific plate and instrumentation system (Acumed LLC, Oregon, USA). A total of 39 patients underwent TO and 62 patients underwent OO between 2007 and 2016. The main outcomes compared were rate of union, duration of radiological healing, implant removal rate and other complications. The two groups were comparable with regards to demographics, side operated and smoking status ( > 0.05). Amongst the TO group; 36 out of 39 patients (92.3%) achieved union, 3 patients (7.7%) developed non-union. Six out of the 36 healed TO (16.6%) required removal of hardware due to implant-related pain. No other complications were recorded amongst TO group needing surgical intervention. Amongst the OO group, 2 of the early cohort of 62 patients (3.2%) sustained acute failure of the metalwork due to technical error. One of the remaining 60 patients (1.6%) developed non-union giving an overall union rate of 95.2%. Two patients out of 59 healed OO (3.3%) required removal of hardware. Although there were 2 early failures, there was a trend towards improved union rate with OO, but this did not reach statistical significance ( > 0.05). There was a significantly higher hardware removal rate recorded in TO group ( = 0.023). The OO showed shorter duration for radiological healing than TO ( < 0.05). USO performed with an OO and fixed with procedure specific plate has lower implant removal rate, a shorter duration for radiological healing and comparable union rate to TO fixed with DCP, but needs careful attention to detail.
尺骨缩短截骨术（USO）是治疗尺骨撞击综合征的一种成熟手术。已经描述了各种类型的截骨术。本回顾性队列研究比较了横向截骨术（TO）与斜形截骨术（OO）的结果，前者使用小型片段动力加压钢板（Synthes，宾夕法尼亚州，美国）固定，后者使用特定手术的钢板和器械系统（Acumed LLC，俄勒冈州，美国）固定。2007 年至 2016 年间，共有 39 例患者接受 TO 治疗，62 例患者接受 OO 治疗。比较的主要结果是愈合率、影像学愈合时间、植入物取出率和其他并发症。两组在人口统计学、手术侧和吸烟状况方面具有可比性（>0.05）。在 TO 组中，39 例患者中有 36 例（92.3%）达到了愈合，3 例（7.7%）发生了不愈合。36 例愈合的 TO 中有 6 例（16.6%）因植入物相关疼痛而需要取出内固定。TO 组中没有其他需要手术干预的并发症。在 OO 组中，62 例早期患者中有 2 例（3.2%）因技术错误导致金属植入物急性失效。其余 60 例患者中有 1 例（1.6%）发生不愈合，总的愈合率为 95.2%。59 例愈合的 OO 中有 2 例（3.3%）需要取出内固定。虽然早期有 2 例失败，但 OO 的愈合率有改善的趋势，但没有达到统计学意义（>0.05）。TO 组的内固定取出率明显更高（=0.023）。OO 的影像学愈合时间比 TO 短（<0.05）。用特定手术钢板固定的 OO 进行 USO 具有较低的植入物取出率、较短的影像学愈合时间和与 DCP 固定的 TO 相当的愈合率，但需要注意细节。
