Clinical Analysis of Ulnar Transverse Shortening Osteotomy in Treatment of Ulnar Positive Variance

Abstract

Objective: To comprehensively analyze the clinical efficiency of ulnar transverse shortening osteotomy in the treatment of ulnar positive variance’s various symptoms. Methods: Retrospective analysis of medical records of 25 patients with ulnar positive variance’s various symptoms were treated in our hospital with transverse shortening osteotomy of the ulnar from July 2011 to May 2020, the preoperative and postoperative ulnar variation, wrist joint activity, radioulnar deviation range, forearm rotation degree, pain degree at wrist activity, handgrip strength, modified Sarmiento wrist score and change of upper limb function DASH score were compared to evaluate the clinical effect of the surgery. Results: 25 patients were fully followed up. All patients achieved bone healing. The changes in the preoperative and postoperative ulnar variation, wrist joint activity, radioulnar deviation range, forearm rotation degree, handgrip strength and upper limb function were compared. The positive variation of ulna was significantly improved after surgery. The mobility of the wrist was improved to some extent, especially hand grip strength and pain significantly compared with that before surgery. The range of motion to the healthy side gained limited increments from (75.1 ± 10.1)% to (89.1 ± 10.3)% for wrist flexion-extension, from (62.3 ± 7.9)% to (87.8 ± 11.2)% for ra-dioulnar deviation, and from (76.3 ± 8.2)% to (91.8 ± 8.1)% for forearm rotation. The grip strength to the healthy side increased from (62.1 ± 10.1)% to (90.2 ± 9.5)%. The pain VAS score reduced from (4.6 ± 1.2)% to (0.7 ± 0.5). At the last follow-up, the modified Sarmiento to wrist score averaged 89.1 points, with 16 excellent, 6 good, 2 fair and 1 poor. The excellent and good rate was 88.0%. Besides, the DASH score of upper limb function after surgery was obviously decreased compared with that before surgery (55.1 ± 9.5) points vs. (25.2 ± 8.7) points. Conclusion: Ulnar transverse shortening osteotomy in the treatment of ulnar positive variance’s various symptoms can alleviate wrist pain, improve wrist joint function and enhance handgrip strength. It’s an effective treatment.