A Novel Method for Precise Ulna-Shortening Osteotomy

Abstract

Abstract Background: Ulnar impaction syndrome caused by positive ulnar variance often requires ulnar shortening osteotomy (USO) to unload the ulnocarpal joint. The therapeutic effect of USO in treatment of ulnar impaction syndrome is limited due to complications such as hardware irritation, non-union rotation and angulation. Despite various devices have been introduced to overcome these limitations, more accurate and simple devices are still needed. The purpose of this study was to introduce a novel method of the ortho-bridge fixation system combined with 3D-printed guide plate to achieve precise ulnar shortening osteotomy with less complications simply. Methods: This was a retrospective study comprising nine patients with ulnar impaction syndrome who underwent ulnar shortening osteotomy by this method. The CT scan data of patients were retrieved for printing the osteotomy guide plate. The ortho-bridge system served as ulnar shortening and internal fixation. The outcome measurements included the time to union, complications, range of motion, grip strength and wrist pain. Results: The ulna was shortened successfully in all of the nine cases without rotation and angulation. Non-union was not observed in any of the cases during follow-up between 12 months after surgery. The range of motion, grip strength and wrist pain also improved following surgery (p<0.05). Conclusion: The ortho-bridge internal fixation system combined with 3D-printed osteotomy guide effectively simplified the procedure, and restored ulnar variance without rotation, angulation and non-union. It is a reliable method for treating ulnocarpal impaction syndrome through ulnar shortening osteotomy.