Ulnar shortening with the ulna osteotomy locking plate.
Summary of "Ulnar shortening with the ulna osteotomy locking plate."
OBJECTIVE:
Ulnar shortening for ulnocarpal unloading using a new device enabling parallel osteotomy, rotation-secured compressive shortening, lag screw placement and hybrid stabilization combined in a solely locking plate construct.
INDICATIONS:
Idiopathic ulnar impaction syndrome. Posttraumatic radial shortening without major tilting of the radius in the sagittal or frontal plane, rotation deformity and/or translation of the distal fragment.
CONTRAINDICATIONS:
Advanced arthritis of the distal radioulnar joint (DRUJ), DRUJ type III according to Tolat, malunion of the distal radius with major tilting of the radius in the sagittal or frontal plane, rotation deformity and/or translation of the distal fragment. SURGICAL
TECHNIQUE:
Mounting of the UOL plate system on the palmar surface of the ulna using standard ulnopalmar exposure. Two parallel 45° osteotomies are performed using an osteotomy guide followed by rotation secured shortening and compression. Stabilization is gained by inserting an interfragmentary lag screw perpendicular to the osteotomy site and applying locking and compression screws. POSTOPERATIVE
MANAGEMENT:
Lower arm cast for 4 weeks until radiological signs of bone healing become apparent. To limit negative influence of rotational forces during bone healing, patients were instructed to limit forearm rotation up to 30° in pro-/supination.
RESULTS:
Sixteen ulnar shortening osteotomies were performed in 15 patients (6 men, 9 women, average age 49 years) and evaluated retrospectively. In 10 cases a trauma-related pathology was the indication for the procedure. The average follow-up time was 53 weeks (range 12-93 weeks). Bone union was observed at a median of 10 weeks (range 6-33 weeks). Overall good clinical results could be achieved with an average shortening of 3.7 mm (range 2.1-16 mm). In this series, there was one nonunion.
Affiliation
Departement for Trauma Surgery and Sports Medicine, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria, gernot.schmidle@uki.at.
Journal Details
This article was published in the following journal.
Name: Operative Orthopadie und Traumatologie
ISSN: 1439-0981
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22743629
- DOI: http://dx.doi.org/10.1007/s00064-011-0037-7
Medical and Biotech [MESH] Definitions
Osteotomy, Le Fort
Transverse sectioning and repositioning of the maxilla. There are three types: Le Fort I osteotomy for maxillary advancement or the treatment of maxillary fractures; Le Fort II osteotomy for the treatment of maxillary fractures; Le Fort III osteotomy for the treatment of maxillary fractures with fracture of one or more facial bones. Le Fort III is often used also to correct craniofacial dysostosis and related facial abnormalities. (From Dorland, 28th ed, p1203 & p662)
Ulnar Nerve Compression Syndromes
Ulnar neuropathies caused by mechanical compression of the nerve at any location from its origin at the BRACHIAL PLEXUS to its terminations in the hand. Common sites of compression include the retroepicondylar groove, cubital tunnel at the elbow (CUBITAL TUNNEL SYNDROME), and Guyon's canal at the wrist. Clinical features depend on the site of injury, but may include weakness or paralysis of wrist flexion, finger flexion, and ulnar innervated intrinsic hand muscles, and impaired sensation over the ulnar aspect of the hand, fifth finger, and ulnar half of the ring finger. (Joynt, Clinical Neurology, 1995, Ch51, p43)
Cubital Tunnel Syndrome
Compression of the ULNAR NERVE in the cubital tunnel, which is formed by the two heads of the flexor carpi ulnaris muscle, humeral-ulnar aponeurosis, and medial ligaments of the elbow. This condition may follow trauma or occur in association with processes which produce nerve enlargement or narrowing of the canal. Manifestations include elbow pain and PARESTHESIA radiating distally, weakness of ulnar innervated intrinsic hand muscles, and loss of sensation over the hypothenar region, fifth finger, and ulnar aspect of the ring finger. (Joynt, Clinical Neurology, 1995, Ch51, p43)
Neural Plate
The region in the dorsal ECTODERM of a chordate embryo that gives rise to the future CENTRAL NERVOUS SYSTEM. Tissue in the neural plate is called the neuroectoderm, often used as a synonym of neural plate.
Ulnar Neuropathies
Disease involving the ULNAR NERVE from its origin in the BRACHIAL PLEXUS to its termination in the hand. Clinical manifestations may include PARESIS or PARALYSIS of wrist flexion, finger flexion, thumb adduction, finger abduction, and finger adduction. Sensation over the medial palm, fifth finger, and ulnar aspect of the ring finger may also be impaired. Common sites of injury include the AXILLA, cubital tunnel at the ELBOW, and Guyon's canal at the wrist. (From Joynt, Clinical Neurology, 1995, Ch51 pp43-5)
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