Different Ulnar-shortening Osteotomy To The Treatment Of Ulna Impaction Syndrome

Objectives The study aimed to identify the clinical effects and indication in the treatment of ulnar impaction syndrome with diffrernt ulnar shortening osteotomy.Methods A total of 44 patients were included who underwent ulnar osteotomy in the North China University of Science and Technology from January 2010 to January 2014 for ulnar impaction syndrome. All patients in our study were divided into three groups sequence: group A(the distal ulna horizontal osteotomy group,13 cases), group B(the distal ulna trapezoid osteotomy group,15 cases) and group C(the distal ulna metaphysis oblique osteotomy group, 16 cases). Opreative incision length、opreative time、fracture healing time and bleeding volumn were measured respctively among perioperative,and ulna variation 、Mayo score、cross end healing time and VAS scores of three groups were compared.Results 1 The difference in sex、course of disease、side、combanition radius situation,and unlar varince status among three were not statistically significant(p>0.05).2 The Mayo score was used to assess wrist joint pain degree 、function、range of motion and grip strength. The postoperative Mayo wrist score of three groups was significantly higher than preoperative,from 30(25,35.25) to 90(85, 93.75)(P<0.05).3 The ulnar variance rate decreased from 93.81% preoperatively to 6.81% postoperatively(P<0.05). The mean preoperative ulnar variance value was(0.35±0.21)cm,decreased to(-0.30±0.13)cm after surgery(P<0.05).There was an improvement in ulnar variance.4 The difference in length of incision、operative time、fracture healing time among three groups were statistically significant(P<0.05). Group C is superior to other two groups.All groups were operated under limb tourniquet,and there was no difference in bleeding volumn among three groups.5 Preoperative VAS scores of three groups were significantly lower than preoperative, statistically significant(P<0.05). The VAS score 6 months after surgry was lower than 3 months. There was an improvement in patients’ symptoms of unlar wrist pain. Group C was superior to other two groups in reducing further pain.Conclusions Three different osteotomy in the treatment of ulnar impaction syndrome can obtain satisfactory curative, effect distal ulna metaphysis osteotomy is an ideal method for ulna impaction syndrome.Not only can it check and repair the scathing triangular fibrocartilage plates,but also brought out further reduction in pain.Besides,it shorten healing fracture time and easily to operat.