Wrist arthroscopy combined with oblique ulnar shortening osteotomy for ulnar impingement syndrome

Abstract

Objective \nTo explore the clinical efficacy of wrist arthroscopy combined with oblique ulnar shortening osteotomy for the treatment of ulnar impingement syndrome. \n \n \nMethods \nFrom March 2015 to March 2017, 16 patients with ulnar impingement syndrome (all unilateral lesions) were treated with wrist arthroscopy to clean up the triangular fibrocartilage complex (TFCC) and then with oblique ulnar shortening osteotomy and plate internal fixation. The postoperative regular follow-up was performed. The clinical efficacy was assessed by preoperative and postoperative ulna variation, modified Mayo wrist score and visual analogue scale (VAS). \n \n \nResults \nAll the patients were follow-up for 6 to 12 months with an average of 10 months. All the oblique osteotomy of ulna achieved bony union. The average healing time was 12 weeks. X-ray examination outcome showed that the mean value of preoperative ulnar variation was (3.3±1.2) mm and decreased to (-0.2±0.5) mm after the operation. The mean preoperative VAS score was 8.2±0.8 and decreased to 3.1±1.6 postoperatively. The pain was completely relieved in 7 patients and significantly relieved in 9 patients. The modified Mayo Wrist Score was 60.8±12.5 preoperatively and increased to 82.3±11.8 postoperatively. The result was rated as excellent in 5 cases, good in 8 cases and fair in 3 cases. The difference was statistically significant before and after operation (P < 0.05). \n \n \nConclusion \nWrist arthroscopy combined with oblique ulnar shortening osteotomy for ulnar impingement syndrome has the advantages of fast functional recovery and effective relief of wrist pain. Meanwhile, oblique osteotomy reduces the risk of fracture nonunion. This treatment is worth promoting. \n \n \nKey words: \nArthroscopes;\xa0Treatment outcome;\xa0Ulnar impingement syndrome;\xa0Oblique osteotomy