Ulnar Shortening Osteotomy for Ulnar Wrist Pain.
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We reviewed the clinical symptoms and the radiographical findings of patients complaing of ulnar wrist pain and evaluated the results of ulnar shortening osteotomy for this disorder.Since 1988 10 patients had ulnar shortening osteotomy, nine male and one female, with an average age of 30.2 years (range: 14-66). These patients complained of severe pain in the ulnar side of the wrist in spite of conservative treatment. On preoperative roentgenograms, the average ulnar variance was +2.5mm ranging from -2.0mm to +6.0mm. Arthrography was performed on all 11 wrists and MRI in 3 wrists. These examinations indicated perforation of the Triangular Fibrous Cartilage Complex in 7 wrists. The average duration of follow-up was 12.4 months, ranging from 7 to 20 months.Using Cooney's clinical scoring system, the average clinical score was 89, ranging from 53 to 59 (full mark 100 points). No one complained of pain. All patients returned to their original occupation. In two patients with disorder of the distal radioulnar joint, the range of pronation and supination was restricted. Postoperative roentgenograms showed the average ulnar variance to be +0.2mm ranging from -4.0mm to 2.0mm. The average amount of ulnar shortening was +2.5mm ranging from 1.5mm to 6.0mm. No significant correlation was found between the postoperative ulnar variance, the amount of ulnar shortening and clinical results.Ulnar shortening osteotomy is considerd a useful procedure for patients with ulnar wrist pain.
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