Predictors of Pain Intensity and Functional Limitation After Conservative Treatment in Idiopathic Ulnar Impaction Syndrome: High Work-Related Exposure or Degenerative Complex TFCC Tear Inevitably Results in Surgical Treatment of Idiopathic Ulnar Impaction Syndrome

Abstract

\n Background: This study aimed to identify predictors of pain intensity and functional limitation after conservative treatment in idiopathic ulnar impaction syndrome (UIS).Methods: One hundred seventy-seven patients with UIS who inevitably underwent ulnar shortening procedures because of considerable pain or functional limitation despite at least 6 months of conservative treatment were included. To identify the predictors of pain intensity and functional limitation after appropriate conservative treatment in UIS, pain intensity was estimated using the visual analog scale (VAS)score, while functional limitations of the wrists were evaluated by the Disabilities of the Arm, Shoulder, and Hand score (DASH; subjective functional limitation), wrist range of motion, and grip strength (objective functional limitation) just before surgery. We considered sex, age, dominance of the affected wrist, work-related exposure, length of ulnar variance, types of distal radioulnar joint (DRUJ) on the coronal, degree of ulnocarpal degeneration, presence of degenerative complex triangular fibrocartilaginous complex (TFCC) tear, and presence of bony lesions (cyst or sclerosis or erosion of lunate or triquetrum or ulnar head) as possible predictors of pain intensity and functional limitations of the wrists. The relationship between pain intensity and functional limitation and the possible predictors were statistically analyzed using a linear regression test.Results: Only work-related exposure was positively correlated with pain intensity and subjective functional limitation. The degenerative complex TFCC tear was a common predictor of an objective functional limitation.Conclusions: Patients with unavoidable excessive wrist use and degenerative complex TFCC tears tended to have more significant pain intensity and functional limitations despite at least 6 months of conservative treatment. Early surgical treatment should be considered for these patients.